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Does raised levels of C-reactive, alpha 1 and 2, and LDH, and low levels of percent transferrin saturation conclude lupus or cancer?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At April 10, 2023
Reviewed AtOctober 11, 2023

Patient's Query

Hello doctor,

This query is for my girlfriend, basically, we did a flow cytometry test and we found a couple of high results I am worried about it and I need a second opinion. The flow cytometry was fine and no abnormality was found. Let me attach some pictures for you. ANA test was negative, a recent test done last year and negative again four years back too when she had her fixed drug eruption genital ulcer. Free light chain tests were normal and within limits. IgG or IgA or IgM serums are within normal. C-reactive, alpha 1 and 2, albumin, and LDH are the only ones that are slightly raised and also percent transferrin saturation was 13 % normal range (20 to 50 %). My mind always races to something bad like lupus or cancer. She has disc degeneration of L5 or S1. Kindly suggest.

Hello,

Welcome to icliniq.com.

Your reports (attachment removed to protect the patient's identity) review is perfectly normal as mentioned in flow cytometry. Globulin is only one or two digits up and albumin is one or two digit low. As it is not clinically significant so it is taken as normal. So, in short, except for disc changes, all are taken as normal.

Thank you.

Patient's Query

Hello doctor,

As you might notice, I am a person that worries so much. When I started searching on the internet " What causes alpha 1 globulin to be high?" it always said it is due to chronic inflammatory disease. Does it mean that this is an indicator of a disease? Also, is it true that alpha-1 globulin gets high always because of a disease? I will keep asking questions to understand better. I am worried as around eight results are high.

Hello,

Welcome back to icliniq.com.

When albumin is increased significantly then it may be true. Otherwise, it is taken as normal. You can repeat these tests after two months if there is a progressive increase then we can discuss it.

Thank you.

Patient's Query

Hello doctor,

We took the test again after one month some results stabilized but some went up like CRP was 7.2 mg/dL and now 10 mg/dL. Alpha-2 was 9.2 g/dL and now 10 g/dL. Alpha-1 percentage is now within range and also it went from 3.8 g/dL to 3.7 g/dL a bit lower. What does this mean should I start worrying now? Does this indicate a tumor or something? Here are the pictures attached, please compare them to the older results.

Hello,

Welcome back to icliniq.com.

I have seen the reports attached (attachment removed to protect the patient's identity). Your total protein and albumin are normal. Some fraction of globulin is very minimally elevated, which is not significant because there is no monoclonal band. The only significant thing is urine showing high WBCs (white blood cells). If you have any urinary problem like dysuria then it is an infection and you need to take antibiotics. I will suggest repeating only urine analysis to confirm infection and starting antibiotics like Ciprofloxacin 500 mg twice a day for a week.

Thank you.

Patient's Query

Hello doctor,

CRP is 10 and ESR is 32, which is high right? We cannot find what is causing high ESR and high CRP. No infection in urine, can urine infection cause elevated levels?

Hello,

Welcome back to icliniq.com.

As I mentioned earlier urine test result shows 500 WBCs, which clearly indicates infection. To confirm it better repeat urine analysis. Any infection can cause increase in CRP and ESR.

Thank you.

Patient's Query

Hello doctor,

I also forgot to mention that she has L5 or S1 degeneration, can that have an effect on elevated ESR and CRP, CK serum, and alpha? Also, how come CRP, ESR, CK, and alpha were elevated but not platelets?

Hello,

Welcome back to icliniq.com.

Spine degenerative changes can not cause high CRP and ESR. Both ESR and CRP are acute reactants mean they usually increase acute inflammation like infection, etc. Kindly repeat the urine examination and upload the report.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply,

I do not think it is a urine infection because she does not have any symptoms. Also, two months ago, we did the same blood test and they were already elevated two months ago. CRP was 7.2 and now 10, ESR is now 32, I do not know how much it was two months ago because it did not show up. Alpha 2 was 9.2 and now 10. I think if it was a UTI (urinary tract infection) it would have cleared within two months. Values increased, and we cannot find what is causing all of these elevated values. How can I not be worried about cancer or tumors or malignancies?

HeIlo,

Welcome back to icliniq.com.

I can assure you that there is no evidence of any cancer as per these reports. Last urine exam.was showing 500 WBCs, which is why I suggested you repeat the urine test.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Abdul Aziz Khan
Dr. Abdul Aziz Khan

Medical oncology

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