What follow-up laboratory tests might be ordered to assist in establishing a definitive diagnosis? What is the nature of the protein found in the urine? What is the most significant laboratory finding in this disorder?
This 58-year-old nuclear power plant worker saw his family physician because of increasing fatigue and weakness. He also reported pain in his lower back and arms when he walks. Physical examination revealed that the man had pale mucous membranes and hepatosplenomegaly. The physician orders a complete blood count (CBC) and urinalysis (UA). A follow-up appointment is scheduled for the following week.
Laboratory Data
The CBC revealed that the patient had anemia. His leukocyte count and differential count were normal, except for a rouleaux (rolled coin) appearance of the RBCs. The UA was normal. The patient was called and requested to return to the laboratory for additional tests. The physician ordered an ESR, kidney screening profile, liver blood profile, and radiographic skeletal survey, with the following results:
- ESR—50 mm/hr
- Kidney profile—normal
- Liver profile—normal, except for increased globular protein
- Skeletal survey—bone lesions in various sites
- What follow-up laboratory tests might be ordered to assist in establishing a definitive diagnosis?
- What is the nature of the protein found in the urine?
- What is the most significant laboratory finding in this disorder?
- What type of immunologic defect exists in this disease process?
- Does this patient have a risk of occupational exposure?
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