Gastrointestinal Pathology - Case 8 - Part 1
   

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GI Index

Library

Olympus Web

RadWeb

Main Index

Reference Values

 

The patient is a 77-year-old male who presented to his primary care physician on February 26, 2003 for a routine six-month check-up. He had no complaints but on questioning admitted to a decreased appetite and 4 pound weight loss.

Labs revealed an increased alkaline phosphatase (142 U/L), mild microcytic anemia (hematocrit 38 %) and a mildly elevated prostate specific antigen (PSA).

On March 16 the patient woke up suddenly from sleep with severe, sharp, constant right upper quadrant pain that lasted two to three hours and was associated with a fever.

His work-up includied: a negative cardiac stress test, multiple negative prostate biopsies and a colonoscopy that revealed a small adenomatous polyp.

He was admitted one month later.

Test Result   Reference

WHITE BLOOD CELL COUNT

6.4 K/uL

 

3.2-10.6

HEMOGLOBIN

12.9 g/dL

L

14.6-17.8

HEMATOCRIT

36.3 %

L

40.8-51.9

PLATELETS

227 K/uL

 

177-406

 

Test Result   Reference

ALKALINE PHOSPHATASE

516 U/L

H

38-126

POTASSIUM

4.2 mmol/L

 

3.3-5.0

SODIUM

138 mmol/L

 

136-144

BILIRUBIN, TOTAL

1.7 mg/dL

H

0.2-1.3

CALCIUM, SERUM OR PLASMA

8.3 mg/dL

L

8.4-10.2

ALBUMIN

3.1 g/dL

L

3.5-4.6

TOTAL PROTEIN

7.5 g/dL

 

6.3-8.2

ASPARTATE AMINOTRANSFERASE

182 U/L

H

15-59

CARBON DIOXIDE

30 mmol/L

H

22-29

ALANINE AMINOTRANSFERASE

133 U/L

H

13-72

 

1. What is your differential diagnosis?