Monday, September 22, 2014

Week 24 Labs

My recent labs are now final.

Of note:

CD19 Recovery
On the last 2 months tests my CD19 cells are in the normal range. This represents B cell reconstitution. This is not a good or bad thing. B cells can be their own problem in MS and are treated in refractory cases with Rituximab when no other med will control symptoms.

Rituximab is also an add-on to Lemtrada that I am considering to stave off the autoimmune side effects (Thyroid disorder, ITP and Goodpastures). Rituximab would be given as an IV about every 4-6 months when the CD19% rises above 1%. I am not sure I am going to take this route.

Lymphocytes (WBCs)
Are recovering but still have not made a full recovery.

B12 & Vitamin D
Both are in the normal range. I take supplements to maintain these levels. My Vit D level is 54. Closer to 100 is better for MS patients so I will continue to supplement and monitor this. For B12 I get monthly injections to maintain this level.

Thyroid
Not preformed, due at next lab draw 10/17/14.

The labs are getting too large to embed here. If you want to see the whole chart go here:

Note: links to labs updated 3/28/16

If that doesn't work someone please let me know. I made it a 'non-public' document and I cannot tell if it will open for others.

Here below is my baseline, first month's labs and the last two lab results:

Baseline
2014



CMP
Mar 25
May 2
Aug 23
Sept 20
Normal Range
Glucose
70
86
82
92
65-99
mg/dL
BUN
16
17
19
29
7-25
mg/dL
Creatinine
0.94
0.96
1.09
1.26
.5-1.10
mg/dL
eGFR
76
74
63
53
> OR = 60
mL/min/1.73m2
B/Creatinine Ratio
n/a
n/a
74
23
6-22
(calc)
Sodium
139
138
138
135
135-146
mmol/L
Potassium
3.6
4.9
4.1
4.6
3.5-5.3
mmol/L
Chloride
106
106
103
10.4
98-110
mmol/L
Carbon Dioxide
25
23
25
22
19-30
mmol/L
Calcium
8.7
9.1
9.4
9.7
8.6-10.2
mmol/L
Protein, Total
5.7
6
6.6
6.9
6.1-8.1
g/dL
Albumin
3.7
4.2
4.2
4.3
3.6-5.1
g/dL
Globlulin
2
1.6
2.4
2.6
1.9-3.7
g/dL
Albumin/Globulin Ratio
1.9
2.3
1.8
1.7
1.0-2.5
(calc)
Bilirubin total
0.3
0.4
0.3
0.3
0.2-1.2
mg/dL
Alkaline Phosphatase
80
76
54
57
33-115
U/L
AST
15
15
16
19
10-30
U/L
ALT
13
12
20
21
6-29
U/L

CBC
Baseline
May 2
Aug 23
Sept 20
Normal Range
White Blood Cell Count
9.3
3.2
4.3
3.7
3.8-10.8
Thousnd/uL
Red Blood Cell Count
4.45
4.5
4.46
4.36
3.90-5.10
Million/uL
Hemoglobin
13.1
13.4
12.8
13.1
11.7-15.5
g/dL
Hematocrit
38.6
39.8
38.2
38.2
35-45
%
MCV
86.7
88.5
85.6
87.6
80-100
fL
MCH
29.3
29.7
28.7
30
27-33
pg
MCHC
33.8
33.5
33.5
34.3
32-36
g/dL
RDW
14.9
16.9
16
15.2
11-15
%
Platelet count
183
228
187
198
140-400
Thousnd/uL
Absolute Neutrophils
4957
2854
3032
2498
1500-7800
cells/uL
Absolute Lymphocytes
3357
112
525
673
850-3900
cells/uL
Absolute Monocytes
660
205
323
307
200-3900
cells/uL
Absolute Eosinophil
288
22
387
196
15-500
cells/uL
Absolute Basophils
37
6
34
26
0-200
cells/uL
Neutrophils
53.3
89.2
70.5
67.5

%
Lymphocytes
36.1
3.5
12.2
18.2

%
Monocytes
7.1
6.4
7.5
8.3

%
Eosinophils
3.1
0.7
9
5.3

%
Basophils
0.4
0.2
0.8
0.7

%








Thyroid
Baseline
May 2
Aug 23
Sept 20
Normal Range
TSH
1.45
0.95


.40-4.50
mU/L
Reflex to T4
n/a
n/a







T & B Subset
Baseline
May 8
Aug 23
Normal Range
% CD3 (Mature T Cells)

7
19
22
57-58
%
Absolute CD3+ cells

<20
103
114
840-3060
cells/uL
% CD4 (Helper Cells)

3
11
11
30-61
%
Absolute CD4+ cells

<20
59
59
490-1740
cells/uL
% CD8 (Suppressor T Cells)

3
9
10
12-42
%
Absolute CD8+ cells

<20
49
52
180-1170
cells/uL
Helper/Suppressor Ratio

1.1
1.21
1.13
.86-5.00

% CD19 (B Cells)

3
45
29
6-29
%
Absolute CD19+ cells

<20
241
153
110-660
cells/uL
Absolute Lymphocytes

138
542
524
850-3900
cells/uL






Vitamins
Baseline
May 2
Aug 23
Sept 20
Normal Range
B-12
939


721
200-1100

Folate
12.4


17.2
none

Vitamin D, 25-OH, total
44


54
30-100

Urine
Baseline
May 8
Aug 23
Sept 20
Normal Range
Glucose

Neg
Neg
Neg
65-99

Protein, Total

Neg
Neg
Neg
6.1-8.1