Several abnormalities on CBC, CMP, PT

[Lynnette171]

I am awaiting surgery for recurring strep and tonsillitis, and went to a hematologist to get clearance for the surgery due to an abnormal Factor VIII. Unfortunately, the doctor I chose has been less than helpful in assisting me, and I am confused about some of the labs. I am currently seeking a second opinion, however, I am not sure if these issues (which he told me were perfectly normal despite never having had results like these before) are something I should press and try to get an appointment sooner about. I do have a dx of discoid lupus, migraine, and asthma. I have a complete set of labs run at least every 3 months due to the lupus, and the only one that ever comes back abnormal is the C4. Here are the lab results (I only listed the abnormal labs):
(test-result-flag-ref. range)
CBC
RBC 3.98 (low)(4.2-5.4)
HCT 35.8 (low)(37.0-47.0)
MCH 31.8 (high)(27.0-31.0)
RDW 11.1 (low)(11.5-14.5)
MPV 7.2 (low)(7.4-11.0)

CMP
Chorlide 108 (high)(98.0-107.0)
SGPT/ALT 11(low)(13.0-69.0)

ESR and C3 were normal, C4 was low (7.5) which is typical for me

I also had a Prothrombin Time (INR) which was low (1.2 with a ref.range of 2.0-3.5) and a seperate Promthrombin Time which was high (12.2 with a ref. range of 8.7-11.5). APTT was 31 with a ref. range of 22-36.

Test for Von Willebrand's was negative. Factor VIII was 51%.

Thanks for the help.

[John Kenyon, CNA]

Hello -

Your lab results are the kind of thing that drive patients crazy if the doctor doesn't take a few moments to explain why they are "normal." The fact is that except for the INR being low, every other result was only a point or two outside normal limits. Doctors know that lab "normal" ranges are all subject to interpretation, and there has to be a cutoff somewhere, but when the results are so extremely close to the normal range (and on either side, depending upon the result one looks at), they really are, for all practical purposes, fine. Just as there are some WNL results that a doctor will not be satisfied with in certain clinical situations, most of the time everything being as close as yours are, and given the doctor's judgement that you are otherwise healthy (except, of course, for the tonsillitis), this actually does make sense. It's too bad he couldn't have taken a moment to explain this to you.

I hope this is helpful. Good luck to you.