What do these blood tests mean?

[vienna_h]

I've been sick for a while, it started with mild chronic gastritis (Dec 2011), odd rashes, fatigue, bloating, stomach/liver pains. Ulcers, h. Pylori, celiac all ruled out. Colonoscopy was clean, gastric emptying test normal, no allergies, no food intolerances. Symptoms first started after a trip to the Amazon (Dec. 2010), including vomiting, malaise, fatigue, low-grade fever. Intolerance to oil and alcohol lasted a coupe months. One year later (Dec 2011), it happens again, but has persisted now for the last 9 months. I had surgery 4 weeks ago, (unrelated, remova of an ovarian cyst) and I have yet to recover, I'm constantly exhausted.

Since I was getting nowhere with a gastroenterologist, I've seen a tropical disease specialist and hematologist. Both suggested a might be having an autoimmune response to a chronic infection or post-infectious response. These are the abnormal test results I've had so far:

August 15 2012:
RBC - 4.02 (normal: 4.2 - 5.4) LOW
MCH - 32.6 (normal: 27 - 31) HIGH
Ferretin - 8 (normal: 20 - 360) LOW
Iron - 10 (normal 9 - 31) NORMAL
Transferrin - 3.72 (normal: 2.13 -3.6) HIGH
Transferrin saturation - 11% (normal 20 - 55%) LOW
(Interpretation: Iron Deficiency)

July 9th 2012:
Mean Cell Hemoglobin - 33 (normal: 27-31) HIGH  
Ferritin - 10.9 (normal: 11.0-306.0) LOW
Iron Level - 46.5 (normal: 11-29) HIGH
UIBC - 33  (normal 26-52) NORMAL
Iron Binding Capacity - 79.5  (normal 43.8-67.0) HIGH
Iron Saturation - 0.58  (normal 0.21-0.42) HIGH


What can I make of this? does it sound like its an Autoimmune Disorder? Maybe Hemolytic Anemia? Chronic Inflammation?

[vienna_h]

PS: I'm a 25 yo female, 18.2 BMI. I suffer from endometriosis and I have idiopathic arrhythmia sometimes,and my BP used to be quite low (90/54) but lately its been higher (110/77), but otherwise super healthy.Non-smoker, light drinker, no drugs. Just birth control pills. I was on nexium (pronton-pump inhibitor) earlier this year but I stopped taking it because I thought I might be allergic. I do not take iron supplements, though I have been taking vitamin C, B and B12 because of my surgery.

I used to be active individual, now I spend 20 hours a day in bed :(

[Ricobord]

Did the tropical medicine doc mention parasites?  You could have easily picked up a parasite that we don't know about or have tests for. Your symptoms sound like some other parasitic infections I have heard of.

Ask your doc if s/he is willing to try an anti-parasitic for a while to see if it helps. You might need to try multiple meds as different meds work for different bugs.  Perhaps there are some lab tests your doc can order to look for unknown parasites.  There is a lab called Metametrix that does a GI analysis looking for parasites in stool samples.

[vienna_h]

I have been tested for some parasites, including Chagas, and some others, so far all negative. I had both blood tests and stool test for parasites. Malaria is the big one I haven't been test for because my low-grade fevers of 38 degrees are too low, but I think I should rule it out anyway.

There is clearly some sort of anemia going on, but I highly doubt it is dietary. And although iron deficient anemia is common in females and I do have all the symptoms, I was not iron deficient when I had heavy menstrations, but since Nov. 2011 I've been taking continuous birthcontrol, so no more periods.

I think it points to chronic infection, and an automimune reaction to that infection where it is still there or not. Likely viral I would assume.

I just don't understand how RBC can be low, MCV normal, and MCH high. Or how my iron is way above normal in July, then borderline low in August. What kind of anemia can do this?

[Ricobord]

I am sorry I don't have any suggestions to offer, except perhaps for one. You might try to call the embassy of the country you visited in S. America and ask how you can get medical information about diseases you could have picked up there.  If they won't help you, then perhaps you could call your own equivalent of the State Department and ask how you can get medical information on what you might have picked up on your travels. Maybe they will be able to help. I hope you find an answer soon!