Have Had Lesions On Body. Suffering From Raynauds And Neurological Symptoms. What Should Be Done?
Also to note - just had spinal tap with the following results -
6/18/12 17:06CSFTYPE FLUID/TUBE #: Tube2 GROSS APPEARANCE: Colorless Clear NUCLEATED CELL: 4 /uL RBC: 29 /uL TOTAL # CELLS: 58 total_# NEUTROPHILS: 3 % LYMPHS %: 73 % MONO/MACROPHAGE: 21 % ATYPICAL CELLS: 3 % GLUCOSE SPINAL FLUID: 61 mg/dL (45-75) PROTEIN CSF: 49 mg/dL (20-50) OLIGOCLONAL IG CSF: No oligoclonal immunoglobulin demonstrated. IGG INDEX CSF: 0.52 (0.28-0.66) IGG CSF: 2.6 mg/dL (0.5-5.9) IGG SERUM: 813 mg/dL (694-1618) ALBUMIN CSF: 26.7* mg/dL (13.9-24.6) ALBUMIN SERUM: 4376 mg/dL (3500-5000)
CBC same date
06/18/12 15:48CBCWBC: 6.6 thou/uL (3.9-10.7) Hemoglobin Blood: 12.6* g/dL (14.0-18.1) PCV BLOOD: 38* % (41-49) PLATELET COUNT: 261 thou/uL (135-371) Red Blood Cells: 4.40* mil/uL (4.50-6.00) MCV: 87 fL (81-98) MCH: 28.6 pg (27.0-32.0) Mean Corpuscle Hemoglobin Concentration: 32.8 g/dL (31.0-35.0) RDWSD: 42.9 fL (37.4-52.4) Red Blood Cells Width Distribution: 13.5 % (11.1-14.3)
concerned about the results of lumbar but doctor was only looking for banding and did not understand the rest of the results. he thought they were normal but I have been told otherwise - particularly the number of RBC/WBC/ml and the atypical cells that should not be present. not tube one and not a hot stick.
thanks,
XXXXXX
Thanks for posting your querry.
It is interesting to go through your history
I think of the following conditions in order of preference.
1. You could be having bullous systemic lupus erythematosus.
The reasons being raynaud,s phenomenon and a space occupying lesion in the pons region
In consistent histo pathology
This could be proved by positive XXXXXXX dsdna tests. If these are negative I think of second choice
2. Polymorphic pemphigoid as lesions are non itchy and not very much bigger in size
3. Dermatitis herpetiformis is a itchy disorder and can be associated with XXXXXXX malignancy. There is no need to worry about few atypical cells in spinal fluid as blood does not show it.
However as skin biopsy is inconclusive only immunoflorescence tests could further give us some clue regarding diagnosis.
Meanwhile pl let me know your medications and if any change in medication if so since when? As blisters or erosions could be induced by drugs.
Awaiting your reply
Prasad pvs