Table 1

Laboratory studies

Parameter

Level

Normal

TSH

13.83 mIU/L

0.30 – 3.94

T3

1.89 pg/mL

2.42 – 4.36

ACTH

1601 pg/mL

5.0 – 47.0

Hematocrit

29.7%

37 – 52

Hemoglobin

9.9 g/dL

12 – 18)

Immunoglobulin G

4040 mg/dL

751 – 1560

Kappa light chains

48.7 mg/dL

absent

Direct Coombs'

positive

negative

Beta-2 microglobulin

4.2 mg/L

1.0 – 1.9

D-dimer

2527 ng/ml

<500

Factor V Leiden mutation

heterozygote

absent

ANA

> 1/1280 "speckled"

absent

RNP/Sm

positive

negative

SS-A/Ro

positive

negative

Test results within normal range: electrolytes (including calcium), glucose, kidney and liver function tests, white blood cell count with differential and platelets, free T4, IgM, IgA, indirect Coombs' test, erythrocyte sedimentation rate, C-reactive protein, troponin T; global coagulation parameters; urine analysis, urinary free lambda light chains; anti-extractable nuclear antigens antibodies (SS-B/La, Scl-70 and Jo-1), anti-dsDNA; anti-mitochondrial (AMA), anti-neutrophil cytoplasmic (ANCA) against myeloperoxidase (MPO) and proteinase-3 (PR3), anti-liver kidney microsomal, anti-parietal cell, anti-transglutaminase IgA and IgG, and anti-cardiolipin IgG and IgM antibodies; rheumatoid factor; angiotensin converting enzyme; complement levels C3 and C4; candida culture, serology on single determination for hepatitis viruses A, B and C, human immunodeficiency virus antigen/antibody, cytomegalovirus, herpes simplex virus-1 and -2, and varicella-zoster virus. Elevated ACTH reduced within days to normal values upon administration of increased doses of cortisone acetate resulting in cortisol levels of around 400 ng/mL (normal range: 65 – 250).

Abbreviations: ANA, antinuclear antibodies; RNP/Sm, combined nuclear ribonucleoprotein Smith antigen.

Adami et al. International Archives of Medicine 2009 2:15   doi:10.1186/1755-7682-2-15