Dr. Goswami Parth Rajendragiri
Pathology
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Patient's Query
Hello doctor,
I have positive ANA, and there was a weak positive Smith antibody (ranging between 2.0 to 3.4, and at times it was negative) through my childhood and teens, and I was monitored for lupus by a pediatric rheumatologist, but I never really exhibited any symptoms. I have abnormal beta 2 glycoprotein that puts me at risk for blood clots. I was told in high school to take a tablet of baby Aspirin every day. I am 28 years old now.
Recently, I had full laboratory tests done for the first time in many years, the results of which are as follows:
I went back to look through all my laboratory tests from my teenage years from a rheumatologist. I saw that I never had high protein. Also, my platelets were normal, so I think the elevated thing is more recent. But it has gone down from 423 three years ago.
I show no active signs of lupus and never truly did. I was always just monitored. I have a copper IUD and occasionally take tablets of Aspirin (81 mg). When I take it often, I bruise super easily. I am just concerned mainly about the protein level. I have read about leukemia and other blood cancers. I was fasting for more than 12 hours and drank no water (I hardly ever do). All other laboratory test results are normal in the metabolic panel and CBC with auto diff. Please help.
Hello,
Welcome to icliniq.com.
We are elated to have you onboard at icliniq.com.
Elevated levels of high total protein do not indicate malignancy alone. It could be due to some temporary infective etiology as well. All other parameters do not indicate any blood cancer. If you have a history of positive beta 2 glycoproteins as mentioned in the above description, then you have to repeat your beta 2 glycoprotein estimation again after 12 weeks.
If two repeated tests for beta 2 glycoprotein are positive and if there is any history of thrombosis, then anti-phospholipid syndrome could be possible or else not. The positive Smith antigen points towards lupus. If asymptomatic, then no need for treatment, and only monitoring can be done. However, you can repeat your Smith antibody estimation again to exclude the possibility of lupus. You can investigate for anti-ds DNA estimation as well to exclude the possibility of SLE (systemic lupus erythematosus).
If the beta 2 glycoprotein result is negative in the repeat test, then no need to take tabletacetylsalicylic acid (Aspirin). Occasional ingestion of tabletacetylsalicylic acid (Aspirin) has no value and is not indicated. You can consult a nearby hematologist for a detailed evaluation.
I wish you good health.
Thank you.
Patient's Query
Hi doctor,
Thank you for your prompt reply.
I have taken several beta 2 glycoprotein tests always of which were positive. With the tablet Aspirin causing bruising sometimes, should I just take it every other day? Also, is the protein level very high or is it just elevated? Does it warrant a re-test, or is there nothing to worry about since the other laboratory reports are at normal levels? Kindly help.
Hello,
Welcome back to icliniq.com.
Antiphospholipid syndrome can be diagnosed when one of the anticardiolipin or anti-beta 2 glycoproteins is positive and clinical criteria is also present as one of the thrombosis attacks or recurrent pregnancy loss. Just based on elevated beta 2 microglobulin, tablet acetylsalicylic acid (Aspirin) cannot be started. Further investigation can be done by assessing Activated Partial Thromboplastin Clotting Time (APTT), kaolin clotting time, Russel viper venom time, and so on. If there is no history of thrombosis, then regular intake of tablet acetylsalicylic acid (Aspirin) is not indicated.
Aspirin can be taken when the risk of thrombosis is high like prolonged bed rest, prolonged immobilization, high cholesterol, high blood pressure, surgery, pregnancy, etc. So you need to discuss all these with your treating hematologist. The anti-phospholipid syndrome is associated with SLE in a few patients. So you need to check your anti-ds DNA and anti-Smith antibody also for SLE workup. Do not panic about just high total protein. You have to repeat your total protein estimation after a few days again to check its level. I suggest you consult a nearby hematologist for your physical examination and discuss all these.
I hope I have answered all your queries.
Thank you.
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Pathology
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