Sir,
Do I need to be treated for Vitamin D deficiency or for Rheumatoid Arthritis? Or do I need to reconfirm for Calcium, Vitamin D and ANA? Kindly suggest on the basis of following clinical results:
Patient:      Madhvi Singh,     Female,          38 Years,     62 Kg,     5’2’’
Complaint:      Pain in ankle, heel, fingers joints, swelling at joints, 7 months
Test Results:           
Date
Investigation      06.02.2014     01.11.2013     14.09.2013     15.03.2013
Hb      10.3 g/dl      10.4 g/dl           11.5 g/dl
Blood Sugar Fasting                     92 mg/dl
Platelets           1.74 lack/cmm          
Erythrocytes           4.17 milli./cumm          
Leucocytes     8100 /cumm     9100 /cumm          
Neutrophil      63%      66%          
Lymphocytes     31%      28%          
Eosinophil      04%      05%          
Monocyte      02%      01%          
Basophil      00%      00%          
ESR 1 hr      32 mm/hr      28 mm/hr          
ESR 2 hr      65 mm/hr      55 mm/hr          
ESR Average     32.25 mm/hr     27.75 mm/hr          
Uric Acid      4.6 mg/dl (f)      5.4 mg/dl     
Serum Calcium           8.9 mg/dl     
Blood Urea     28 gm/dl               
Serum Creatinin 0.9 mg/dl               
RDW           18.47%          
PCV           33.11%          
MCV           79.4 fl          
MCH           24.94 pg          
MCHC           31.41%          
MPV           9.64%          
PDW           8.69%          
PCT           0.17%          
R. A. Factor           18          
TSH (Ultrasensitive)           4.570           2.99
CCPA           0.66 (-ve)          
ANA           Homogenous(+/-)          
25-OH Vit D Total                     13.19
Blood Pressure      110/70      110/70      110/70      110/70

Thanking you,