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Section 7.1 Laboratory

Laboratory Report #20

Date

Collection Date: April 12, 2022
Report Date: April 14, 2022

Laboratory

Labcorp

Ordering Physician

Dr. Rihab Kheir

Report Type

Rheumatology Follow-up / Inflammatory Recovery Evaluation

Laboratory testing included:

  • Comprehensive Metabolic Panel (CMP12+1AC)
  • Complete Blood Count (CBC) with Differential/Platelet
  • Erythrocyte Sedimentation Rate (ESR)
  • C-Reactive Protein (CRP)
  • Creatine Kinase (CK)
  • Aldolase

Original Report

PDF: Labcorp – April 12, 2022

One-Page Summary

Purpose of Testing

This laboratory evaluation was performed as part of continued rheumatology follow-up after the severe systemic inflammatory illness of 2021. The purpose was to monitor for any return of inflammation, assess recovery of blood counts, evaluate kidney and liver function, and determine whether muscle inflammation or injury was present. This report continues the pattern of laboratory normalization and provides additional evidence that the inflammatory episode remained resolved.

Major Findings

Inflammatory Markers

Erythrocyte Sedimentation Rate (ESR)

Result

  • 8 mm/hr

Reference Range:

  • 0–30 mm/hr

Interpretation

ESR remained normal.

Trend:

  • October 2021 peak: 71 mm/hr
  • December 2021: 15 mm/hr
  • February 2022: 13 mm/hr
  • March 2022: 16 mm/hr
  • April 2022: 8 mm/hr

The continued normal ESR confirms sustained control of systemic inflammation.

C-Reactive Protein (CRP)

Result

  • 2 mg/L

Reference Range:

  • 0–10 mg/L

Interpretation

CRP remained normal and unchanged from previous measurements.

Trend:

  • October 2021 peak: 32 mg/L
  • December 2021: 2 mg/L
  • February 2022: 1 mg/L
  • March 2022: 3 mg/L
  • April 2022: 2 mg/L

The persistently low CRP level provides strong evidence that active systemic inflammation remained absent.

Complete Blood Count

Results

  • WBC: 6.4 ×10³/µL
  • RBC: 4.25 ×10⁶/µL
  • Hemoglobin: 13.1 g/dL
  • Hematocrit: 39.7%
  • MCV: 93 fL
  • Platelets: 228 ×10³/µL

Interpretation

Blood counts remained stable and normal.

The anemia associated with the 2021 inflammatory illness had resolved:

  • October 2021 Hemoglobin: approximately 11.4 g/dL
  • April 2022 Hemoglobin: 13.1 g/dL

The normal MCV confirms that red blood cells remained appropriately sized, consistent with recovery from the prior normocytic anemia.

Kidney Function

Results

  • BUN: 18 mg/dL
  • Creatinine: 0.93 mg/dL
  • eGFR: 80 mL/min/1.73 m²

Interpretation

Kidney function remained excellent and stable. No evidence of kidney involvement from the previous inflammatory illness was present.

Electrolytes

Results

  • Sodium: 138 mmol/L
  • Potassium: 4.2 mmol/L
  • Chloride: 100 mmol/L
  • Calcium: 9.0 mg/dL

Interpretation

Electrolytes remained normal.

The previous hyponatremia from the peak inflammatory period had fully resolved:

  • October 2021 Sodium: 129 mmol/L
  • April 2022 Sodium: 138 mmol/L

Liver Function

Results

  • AST: 27 IU/L
  • Alkaline Phosphatase: 67 IU/L
  • Bilirubin: 0.5 mg/dL
  • GGT: 11 IU/L

Interpretation

Liver function remained normal with no evidence of hepatic involvement.

Muscle Inflammation Evaluation

Creatine Kinase (CK)

Result

  • 108 U/L

Reference Range:

  • 30–208 U/L

Interpretation

CK remained normal, indicating no evidence of active muscle injury or muscle breakdown.

Aldolase

Result

  • 2.0 U/L (Low)

Reference Range:

  • 3.3–10.3 U/L

Interpretation

Aldolase remained below the reference range but was not elevated. A low aldolase value does not indicate muscle inflammation or damage. Combined with the normal CK, this report provides no evidence of active inflammatory muscle disease.

Overall Interpretation

This report demonstrates continued recovery and stability following the severe systemic inflammatory illness of 2021. Inflammatory markers remained normal, blood counts remained recovered, kidney and liver function were preserved, electrolytes were normal, and muscle injury markers showed no evidence of active disease. The April 2022 laboratory profile is markedly different from the October 2021 inflammatory crisis and provides strong objective evidence of sustained remission.

Longitudinal Significance

This report contributes to:

  • ESR Trend Table
  • CRP Trend Table
  • Hematology Trend Table
  • Electrolyte Trend Table
  • Kidney Function Trend Table
  • Liver Function Trend Table
  • Muscle Inflammation Trend Table
  • Rheumatology Consultation Summary
  • Systemic Inflammatory Illness Timeline

Clinical Importance

⭐⭐⭐⭐ Sustained Recovery Milestone

This report is important because it confirms that recovery from the 2021 inflammatory illness was comprehensive:

  • Inflammation remained suppressed.
  • Anemia remained corrected.
  • Electrolytes normalized.
  • Muscle injury was absent.
  • Organ function remained stable.

Key Changes Since Previous Report

Compared with March 7, 2022:

  • ESR improved from 16 → 8 mm/hr.
  • CRP improved from 3 → 2 mg/L.
  • Kidney function remained stable.
  • Hemoglobin remained normal (13.1 g/dL).
  • Sodium remained normal (138 mmol/L).
  • CK remained normal.
  • No evidence of recurrent inflammatory disease.

Related Reports

  • August 31, 2021 – Initial Systemic Inflammatory Evaluation
  • October 13, 2021 – Peak Systemic Inflammatory Illness Evaluation
  • December 15, 2021 – Recovery Evaluation
  • January 12, 2022 – Continued Recovery Evaluation
  • February 9, 2022 – Autoimmune Evaluation
  • March 7, 2022 – Sjögren’s Evaluation
  • June 6, 2022 – Inflammation Monitoring Evaluation
  • ESR Trend Table
  • CRP Trend Table
  • Rheumatology Consultation Summary
  • Medical History Timeline

Navigation

  • Previous Report: March 7, 2022 – Sjögren’s Antibody / Inflammation Evaluation
  • Next Report: June 6, 2022 – ESR and CRP Monitoring Evaluation
  • Return to Laboratory Library
  • Return to Health Inventory

Observation

This April 2022 report is another excellent example of why preserving the complete laboratory sequence is valuable. The October 2021 report showed the height of the inflammatory illness:

  • ESR: 71
  • CRP: 32
  • Hemoglobin decline
  • Sodium decline

Six months later, this report shows:

  • ESR: 8
  • CRP: 2
  • Hemoglobin: 13.1
  • Sodium: 138
  • Normal kidney, liver, and muscle markers

The laboratory record clearly documents a severe but reversible inflammatory event followed by sustained recovery. This report strengthens the conclusion that by spring 2022, your body had returned to a stable baseline.