Section 7.1 Laboratory

Laboratory Report #17

Date

Collection Date: February 9, 2022
Report Date: February 15, 2022

Laboratory

Labcorp

Ordering Physician

Dr. Rihab Kheir

Report Type

Rheumatology Follow-up / Autoimmune Evaluation

Laboratory testing included:

Thyroid Stimulating Hormone (TSH)
Free Thyroxine (Free T4)
ABO Blood Grouping and Rh Factor
14.3.3 ETA Rheumatoid Arthritis Marker
Erythrocyte Sedimentation Rate (ESR)
C-Reactive Protein (CRP)

Original Report

PDF: Labcorp – February 9, 2022

One-Page Summary

Purpose of Testing

This laboratory evaluation was performed as part of ongoing rheumatology follow-up after the severe systemic inflammatory illness of 2021. The purpose was to continue monitoring inflammatory activity, evaluate for rheumatoid arthritis-related markers, assess thyroid function, and gather additional information regarding possible autoimmune causes of the previous inflammatory episode. This report demonstrates continued control of inflammation and provides additional evidence against active rheumatoid arthritis.

Major Findings

Inflammatory Markers

Erythrocyte Sedimentation Rate (ESR)

Result

13 mm/hr

Reference Range:

0–30 mm/hr

Interpretation

ESR remained normal.

Compared with previous results:

October 2021 peak: 71 mm/hr
December 2021: 15 mm/hr
January 2022: 6 mm/hr
February 2022: 13 mm/hr

The inflammatory marker remained well controlled, confirming continued resolution of the systemic inflammatory process.

C-Reactive Protein (CRP)

Result

1 mg/L

Reference Range:

0–10 mg/L

Interpretation

CRP remained very low and within the normal range.

Trend:

October 2021 peak: 32 mg/L
December 2021: 2 mg/L
January 2022: 4 mg/L
February 2022: 1 mg/L

This represents sustained resolution of active inflammation.

Rheumatoid Arthritis Evaluation

14.3.3 ETA Rheumatoid Arthritis Marker

Result

<0.20 ng/mL

Reference Range:

<0.20 ng/mL

Interpretation

The 14.3.3 ETA protein marker was negative.

This test is associated with rheumatoid arthritis activity and joint damage risk. A negative result provided additional evidence against active rheumatoid arthritis as the cause of the previous inflammatory illness.

However, as with all autoimmune testing, results must be interpreted with the complete clinical picture rather than as an isolated diagnostic test.

Thyroid Function

Results

TSH: 0.912 μIU/mL
Free T4: 1.33 ng/dL

Interpretation

Thyroid function remained within normal limits.

The TSH value was lower than the October 2021 value (4.17 μIU/mL) but remained within the laboratory reference range. Free T4 remained stable and normal.

These findings indicate continued adequate thyroid hormone regulation.

Blood Type

Results

ABO Group: A
Rh Factor: Positive

Interpretation

This report documents blood type as:

A Positive

The laboratory noted that prior ABO/Rh records were not available for additional verification.

Overall Interpretation

This rheumatology follow-up evaluation demonstrates continued recovery from the systemic inflammatory illness of 2021. Both major inflammatory markers remained normal, with ESR at 13 mm/hr and CRP at only 1 mg/L. The negative 14.3.3 ETA rheumatoid arthritis marker provided additional evidence against active rheumatoid arthritis as the explanation for the prior inflammatory episode. Thyroid function remained stable, and blood typing information was documented for the medical record.

Longitudinal Significance

This report contributes to:

ESR Trend Table
CRP Trend Table
Rheumatology Evaluation
Autoimmune Evaluation
Thyroid Trend Table
Systemic Inflammatory Illness Timeline
Medical History Timeline

It documents continued stability after recovery from the 2021 inflammatory episode.

Clinical Importance

⭐⭐⭐⭐ Autoimmune Evaluation Milestone

This report is important because it adds another piece to the diagnostic picture. The combination of:

Normal ESR
Normal CRP
Negative 14.3.3 ETA rheumatoid arthritis marker
Previously negative RF and ANA testing

made active rheumatoid arthritis increasingly unlikely as the explanation for the 2021 inflammatory illness.

Key Changes Since Previous Report

Compared with January 12, 2022:

ESR increased slightly from 6 → 13 mm/hr, remaining normal.
CRP improved from 4 → 1 mg/L.
Thyroid function remained stable.
Additional rheumatoid arthritis marker (14.3.3 ETA) was negative.
Continued evidence of resolved systemic inflammation.

Related Reports

August 31, 2021 – Initial Systemic Inflammatory Evaluation
October 13, 2021 – Peak Inflammatory Evaluation
December 15, 2021 – Rheumatology Recovery Evaluation
January 12, 2022 – Continued Recovery Evaluation
ESR Trend Table
CRP Trend Table
Autoimmune Evaluation
Rheumatology Consultation Summary
Medical History Timeline

Navigation

Previous Report: January 12, 2022 – Rheumatology Follow-up Evaluation
Next Report: Subsequent 2022 Laboratory Evaluation
Return to Laboratory Library
Return to Health Inventory

Observation

This report is another important confirmation point in the recovery sequence. By February 2022, the laboratory evidence shows a very different picture from October 2021:

Marker	October 2021 Peak	February 2022
ESR	71 mm/hr	13 mm/hr
CRP	32 mg/L	1 mg/L
Hemoglobin	11.4 g/dL	Normalized
Sodium	129 mmol/L	Normalized

The continuing pattern is that the inflammatory crisis was severe but temporary, with measurable recovery across multiple laboratory categories. This report strengthens the conclusion that the episode was an inflammatory syndrome rather than ongoing destructive autoimmune disease such as rheumatoid arthritis.