Blood tests | Figure 1

%27%3e%3cg%20id=%27Group-14%27%20transform=%27translate(13.000000,%20103.176124)%27%3e%3cg%20id=%27Group-Copy-5%27%20transform=%27translate(0.000000,%20182.676124)%27%3e%3crect%20id=%27Rectangle-8%27%20fill=%27%23E2E0DE%27%20x=%270%27%20y=%270%27%20width=%2736%27%20height=%2736%27%20rx=%2718%27%3e%3c/rect%3e%3cpath%20d=%27M28,27.6503435%20C28,22.127496%2023.5228474,17.6503435%2018,17.6503435%20C12.4771525,17.6503435%208,22.127496%208,27.6503435%20M18,16.3472505%20C20.8165136,16.3472505%2023.099749,14.0640151%2023.099749,11.2475015%20C23.099749,8.43098783%2020.8165136,6.1477524%2018,6.1477524%20C15.1834863,6.1477524%2012.9002509,8.43098783%2012.9002509,11.2475015%20C12.9002509,14.0640151%2015.1834863,16.3472505%2018,16.3472505%20Z%27%20id=%27Combined-Shape%27%20fill=%27%23FFFFFF%27%20fill-rule=%27nonzero%27%3e%3c/path%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/svg%3e)

Deleted account

Some actions are only available when you log in.

Blood tests

You can view up to 4 cases without signing up
24 years old male patient came for check up

CBC was done and result

• Hb: 15.7
• RBC: 4.92
• HCT: 42.2
• MCV: 85.7
• MCH: 31.8
• Platelets: 166
• WBC: 5.6
• Blood Glucose: 93 Fasting
• Cholesterol: > 221 *
• Triglycerides: 48
• HDL: 48
• Uric acid: 5

What advice can I give him?

• Is it possible to have a high cholesterol and low TG?

Key Points:

• Adults with rheumatoid arthritis (RA) have an ∼1.5 times higher risk of cardiovascular disease (CVD) even with no traditional CVD risk factors, and incidence rates increase substantially with number of CVD risk factors.
• Low-density lipoprotein (LDL) or high-density lipoprotein (HDL) particles or apolipoproteins (apoB or apoA1) may be more reliable CVD risk factors than cholesterol (total, LDL-cholesterol, or HDL-cholesterol) concentrations because of chronic inflammation.
• In RA, current CVD risk factors likely underestimate the extent of subclinical atherosclerosis.
• Inflammation may directly cause myocardial injury and heart failure.
• Disease activity is a strong risk factor for CVD and mortality and key target for CVD risk reduction.

Severe Combined Dyslipidemia With a Complex Genetic Basis:
A 48-year-old male presented with severe combined dyslipidemia: total cholesterol and TG were 11.5 and 21.4 mmol/L, respectively. He had dyslipidemia since his early 20s, with tuberous xanthomas on his elbows and knees. His body mass index was 42 kg/m2. He also had treated hypertension, mild renal impairment, and a history of gout. He had no history of cardiovascular disease, peripheral arterial disease, or pancreatitis.

Multiple medications had been advised including rosuvastatin, ezetimibe, fenofibrate, and alirocumab, but his lipid levels were never adequately controlled.

Genetic Analysis:

• Targeted next-generation sequencing identified:
  1. the APOE E2/E2 homozygous genotype classically described with familial dysbetalipoproteinemia;
  2. one APOE E2 allele contained the rare heterozygous missense variant p.G145D, previously termed apo E-Bethesda;
  3. a rare heterozygous APOC2 nonsense variant p.Q92X;
  4. a high polygenic risk score for TG levels (16 out of 28 TG-raising alleles) at the 82nd percentile for age and sex.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.