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Section 7.1 Laboratory

Laboratory Report #18

Date

Collection Date: March 7, 2022
Report Date: March 8, 2022

Laboratory

Labcorp

Ordering Physician

Dr. Rihab Kheir

Report Type

Rheumatology Follow-up / Autoimmune Evaluation

Laboratory testing included:

  • Sjögren’s Antibodies:
    • Anti-SS-A (Ro)
    • Anti-SS-B (La)
  • Erythrocyte Sedimentation Rate (ESR)
  • C-Reactive Protein (CRP)

Original Report

PDF: Labcorp – March 7, 2022

One-Page Summary

Purpose of Testing

This laboratory evaluation was performed as part of continued rheumatology follow-up after the systemic inflammatory illness of 2021. The purpose was to evaluate for evidence of Sjögren’s syndrome, an autoimmune condition that can produce systemic inflammation, joint symptoms, fatigue, and other inflammatory manifestations. In addition, ESR and CRP were repeated to confirm continued control of systemic inflammation.

Major Findings

Inflammatory Markers

Erythrocyte Sedimentation Rate (ESR)

Result

  • 16 mm/hr

Reference Range:

  • 0–30 mm/hr

Interpretation

ESR remained within the normal laboratory range.

Trend:

  • October 2021 peak: 71 mm/hr
  • December 2021: 15 mm/hr
  • February 2022: 13 mm/hr
  • March 2022: 16 mm/hr

Although ESR increased slightly from the previous month, it remained normal and provided continued evidence that the severe inflammatory episode had resolved.

C-Reactive Protein (CRP)

Result

  • 3 mg/L

Reference Range:

  • 0–10 mg/L

Interpretation

CRP remained normal.

Trend:

  • October 2021 peak: 32 mg/L
  • December 2021: 2 mg/L
  • February 2022: 1 mg/L
  • March 2022: 3 mg/L

The continued low CRP level confirms the absence of significant active systemic inflammation.

Sjögren’s Syndrome Evaluation

Anti-SS-A (Ro) Antibody

Result

  • <0.2 AI

Reference Range:

  • 0.0–0.9 AI

Interpretation

Negative.

No laboratory evidence of Anti-SS-A antibodies was identified.

Anti-SS-B (La) Antibody

Result

  • <0.2 AI

Reference Range:

  • 0.0–0.9 AI

Interpretation

Negative.

No laboratory evidence of Anti-SS-B antibodies was identified.

Overall Interpretation

This report demonstrates continued recovery and stability following the systemic inflammatory illness of 2021. Inflammatory markers remained normal, with ESR at 16 mm/hr and CRP at 3 mg/L. Testing for Sjögren’s syndrome-associated antibodies was negative, providing additional evidence against this autoimmune condition as the explanation for the previous inflammatory episode.

When combined with earlier negative autoimmune evaluations, including:

  • Rheumatoid factor
  • ANA Direct
  • Anti-dsDNA
  • 14.3.3 ETA rheumatoid arthritis marker
  • Sjögren’s antibodies

the overall laboratory picture showed no evidence of a specific systemic autoimmune disease despite the significant inflammatory episode in 2021.

Longitudinal Significance

This report contributes to:

  • ESR Trend Table
  • CRP Trend Table
  • Autoimmune Evaluation
  • Rheumatology Consultation Summary
  • Systemic Inflammatory Illness Timeline
  • Medical History Timeline

It documents continued remission of the inflammatory process and completion of additional autoimmune testing.

Clinical Importance

⭐⭐⭐⭐ Autoimmune Evaluation Milestone

This report is important because it further narrows the possible causes of the 2021 inflammatory illness. Multiple autoimmune markers were investigated, and no specific autoimmune disease pattern was identified.

Key Changes Since Previous Report

Compared with February 9, 2022:

  • ESR increased slightly from 13 → 16 mm/hr, remaining normal.
  • CRP increased slightly from 1 → 3 mg/L, remaining normal.
  • Sjögren’s Anti-SS-A remained negative.
  • Sjögren’s Anti-SS-B remained negative.
  • Continued evidence of resolved systemic inflammation.

Related Reports

  • August 31, 2021 – Initial Systemic Inflammatory Evaluation
  • October 13, 2021 – Peak Inflammatory Evaluation
  • December 15, 2021 – Rheumatology Recovery Evaluation
  • February 9, 2022 – Autoimmune Evaluation
  • ESR Trend Table
  • CRP Trend Table
  • Autoimmune Evaluation
  • Rheumatology Consultation Summary
  • Medical History Timeline

Navigation

  • Previous Report: February 9, 2022 – Rheumatology Follow-up / Autoimmune Evaluation
  • Next Report: Subsequent 2022 Laboratory Evaluation
  • Return to Laboratory Library
  • Return to Health Inventory

Observation

This report continues to strengthen an important conclusion emerging from the 2021–2022 laboratory sequence:

The inflammatory illness was real and severe, but extensive testing did not identify a specific autoimmune disease.

By March 2022:

  • ESR was normal.
  • CRP was normal.
  • Rheumatoid arthritis testing was negative.
  • Sjögren’s testing was negative.
  • Lupus-related testing was negative.
  • Kidney involvement was absent.

The laboratory record shows a severe inflammatory event followed by a sustained return to normal inflammatory markers. This pattern will be important when creating the “History of Systemic Inflammatory Illness” subsection in Section 3 of the Health Inventory.