Lab Case 48

A 58 year old man on treatment for T cell Lymphoma presents to your ED feeling unwell for the past 3 days. On examination he is tachycardic, tachypnoeic and hypotensive.

His blood results:

Hb   105   (115-135)                                                      Na   132   (137-145 mmol/l)

WCC    427.72  (4-11)                                                   K  8.9  (3.3-5 mmol/l)

Platelets   8  (140-400)                                                  HCO3  23

RCC  3.29                                                                     Urea  6.1  (3-8)

Hct   0.33                                                                      Creatinine  122  (<130)

MCV  100                                                                      Bilirubin   18  (<21)

MCH   31.9                                                                    ALT   28 (35-110)

MCHC   318                                                                  ALP   216 ( <56)

Neutrophil  2.14  (3-7)                                                   GGT  156  (<41)

Lymphocytes  423.45                                                    Albumin   37 (38-50)

Monocytes  2.14                                                            Total Protein    57  (65-85)

Eosinophils   0                                                               Ca   2.01  (2.20-2.55)

CRP   2.9                                                                      PO4    1.07  (0.8-1.5)

INR   1.3                                                                        Mg   0.84   ( 0.7 -1.4)

Fibrinogen   1.7                                                             LDH      1510  (140-280)

Uric acid  0.48  (0.18-0.44)

Questions

1. Describe the abnormalities

2. Interpret your findings

3. What causes these abnormalities?

4. What are your treatment priorities?

5. What conditions are commonly associated with this?