Mary Beth Hahn: Lab Tests

NOTE: Remember that unnecessary laboratory testing wastes precious time and increases health costs for all of us!

Laboratory test results:
Laboratory Test	Results
Routine laboratory work	Within normal limits (WNL), except for mild anemia
Urinalysis	Proteinuria and cellular casts
ANAs anti-DNA anti-ENA (Extractable nuclear antigen)	1:251 (normal: <1:20) 386 U (normal: <70 U) Positive (normal: negative)
ACAs IgG IgM	98 g/L (normal: <23 g/L) 69 mg/L (normal: <11 mg/L)

Kidney biopsy results: The glomerulus stains positive for IgG

Questions:

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1. Do you think the patient's mild anemia is physiological or pathological? Please provide a physiological or pathogenesis for your answer.
2. Now look at the urinalysis results. Are they normal? Which of the following condition might be indicated by these results?: Hemolytic anemia; Liver damage; Kidney damage; Urinary tract infection
3. What do the elevated levels of anti-nuclear antibodies tell you about Ms. Hahn's condition?: Ms. Hahn has an organ-specific autoimmunity disorder.; Ms. Hahn has a systemic autoimmunity disorder.; Ms. Hahn has a primary immunodeficiency disorder.; Ms. Hahn has a secondary immunodeficiency disorder.
4. Do the laboratory results confirm your preliminary assessment? Which autoimmune disorder is affecting Ms. Hahn?: Grave's disease; Myasthenia gravis; Rheumatoid arthritis; Systemic lupus erythematosus
5. How is SLE different from each of these autoimmune disorders? Review your notes and list three distinguishing features for each disorder.: A. Grave's disease; B. Myasthenia gravis; C. Rheumatoid arthritis
6. Compare Ms. Hahn's signs with the ACR Damage Index for SLE. Based on her interview, physical exam, and lab results, which of her signs meet the criteria?
7. How can her condition be treated?