“I have low RDW, high immature granulocytes and a few other things?”
I am a 34-year-old active female. I had knee reconstruction in May of 2021. In August I started having muscle and joint pain. Not constant but bothersome when I felt it. My body just hasn't felt well. I have had random nausea since. I also have spells where one of my hands or feet will fall asleep. On September 21, I had a lab come back with low alkaline phosphatase. Repeated again and was still low in November. Did an ANA in December and it was positive at a titer of 1:80 and a pattern of ac-8,9,10. On Jan 17th I had screws removed from my tibia and a debridement of my knee. Almost 2 weeks post-op from that, I'm feeling good. My knee is much better most recent labs show negative ANA but Low RDW, low sodium, low urine specific gravity, and high immature granulocytes (0.03). I am still having nausea and getting short of breath quickly. I feel like something is off in my body but what could this potentially mean?
Female | 34 years old
Complaint duration: 3 months
Medications: probiotics, birth control, 20mg adderall
6 Answers
It's important to note that specific medical advice should come from a healthcare professional who has access to your complete medical history and can conduct a thorough examination.
The combination of symptoms you've described, including joint pain, muscle pain, nausea, tingling in the hands and feet, low alkaline phosphatase, positive ANA (antinuclear antibody), low RDW (red cell distribution width), low sodium, low urine specific gravity, and high immature granulocytes, is complex and may require further evaluation by a healthcare provider. These symptoms could be indicative of various underlying medical conditions or factors, and it's essential to investigate them comprehensively.
Here are some potential considerations:
1. **Autoimmune Disorders:** A positive ANA, even at a low titer, can sometimes be associated with autoimmune disorders. However, a diagnosis of an autoimmune disorder typically requires further specific antibody testing and clinical evaluation.
2. **Electrolyte Imbalance:** Low sodium levels can cause symptoms such as nausea, muscle weakness, and tingling. An evaluation by a healthcare provider can help determine the cause of your electrolyte imbalance and guide appropriate treatment.
3. **Hematological Abnormalities:** Low RDW and elevated immature granulocytes can be indicative of various blood-related conditions, including certain infections, inflammation, or bone marrow disorders. Additional blood tests and clinical assessment may be needed.
4. **Nausea:** Nausea can have numerous potential causes, including gastrointestinal issues, medication side effects, or systemic conditions. Your healthcare provider can investigate the cause and provide appropriate management.
5. **Muscle and Joint Pain:** These symptoms can have many causes, including inflammatory conditions, musculoskeletal issues, or other underlying medical conditions.
Given the complexity of your symptoms and the range of potential underlying causes, it's crucial to maintain open communication with your healthcare provider. They may recommend further testing, such as additional blood work, imaging studies, or consultations with specialists, to determine the root cause of your symptoms.
Be sure to provide your healthcare provider with a detailed medical history, including the timing and progression of your symptoms. This information will be essential for accurate diagnosis and appropriate treatment planning. If you ever experience severe or worsening symptoms or have concerns about your condition, don't hesitate to seek prompt medical attention.
The combination of symptoms you've described, including joint pain, muscle pain, nausea, tingling in the hands and feet, low alkaline phosphatase, positive ANA (antinuclear antibody), low RDW (red cell distribution width), low sodium, low urine specific gravity, and high immature granulocytes, is complex and may require further evaluation by a healthcare provider. These symptoms could be indicative of various underlying medical conditions or factors, and it's essential to investigate them comprehensively.
Here are some potential considerations:
1. **Autoimmune Disorders:** A positive ANA, even at a low titer, can sometimes be associated with autoimmune disorders. However, a diagnosis of an autoimmune disorder typically requires further specific antibody testing and clinical evaluation.
2. **Electrolyte Imbalance:** Low sodium levels can cause symptoms such as nausea, muscle weakness, and tingling. An evaluation by a healthcare provider can help determine the cause of your electrolyte imbalance and guide appropriate treatment.
3. **Hematological Abnormalities:** Low RDW and elevated immature granulocytes can be indicative of various blood-related conditions, including certain infections, inflammation, or bone marrow disorders. Additional blood tests and clinical assessment may be needed.
4. **Nausea:** Nausea can have numerous potential causes, including gastrointestinal issues, medication side effects, or systemic conditions. Your healthcare provider can investigate the cause and provide appropriate management.
5. **Muscle and Joint Pain:** These symptoms can have many causes, including inflammatory conditions, musculoskeletal issues, or other underlying medical conditions.
Given the complexity of your symptoms and the range of potential underlying causes, it's crucial to maintain open communication with your healthcare provider. They may recommend further testing, such as additional blood work, imaging studies, or consultations with specialists, to determine the root cause of your symptoms.
Be sure to provide your healthcare provider with a detailed medical history, including the timing and progression of your symptoms. This information will be essential for accurate diagnosis and appropriate treatment planning. If you ever experience severe or worsening symptoms or have concerns about your condition, don't hesitate to seek prompt medical attention.
The lab indices you mention esp RDW are not indices we commonly look at- essentially we look at WBC, hemoglobin and hematocrit and platelet count and diff - I would ask your doctor to run that by a Hematology colleague
as for low Alkaline Phosphatase, you should be evaluated to exclude Hypophosphatasia
I hope you feel better!
as for low Alkaline Phosphatase, you should be evaluated to exclude Hypophosphatasia
I hope you feel better!
This is not a question for a gastroenterologist. Please address your question to a hematologist.
I looked up other causes of acquired low alkaline phosphates. They include zinc deficiency, pernicious anemia (causing low B12), and hypothyroidism. Your zinc level and thyroid tests should be checked.
That is something you should check with your primary care physician about.
Hey Dear, I am sorry to hear that you had to go through all this. Getting to the point, low RDW, low sodium, low potassium, and high Immature granulocytes are very non-specific, pointing to no specific illness. Low urine specific gravity can be suggestive of poor oral intake or drinking too much water. Based on the labs above, it's hard to say that anything in your body is amiss. But I would recommend better nutrition and appropriate exercise as allowed by the orthopedic surgeon, to help improve your overall health.
