Suggest treatment for blood in urine , heart palpitations , headache and fatigue
Patient: 94 My labs show elevated platelets, AST, ALT, and bilirubin. There is also blood in my urine and I experience severe headaches and extreme fatigue, along with heart palpitations when I take a hot bath for my sore muscles. Last month my CBC also showed elevated WBC but not this last round of tests. My docs are stumped and are calling it Chronic Fatigue. BP is 156/94 What other tests should I request? Thanks Doctor: Hello!Welcome and thank you for asking on HCM!I read your question carefully and understand your concern. These symptoms may be related to a chronic liver infection or biliary tract infection. High platelets are often a nonspecific sign of inflammation. Blood in urine could be caused by an urinary tract infection or a lesion in the urinary tract , or a coagulation disorder (related to liver dysfunction).I recommend consulting with your GP for a careful physical examination, an abdominal ultrasound and some tests (besides the performed tests): - coagulation tests- Gama GT- alkaline phosphatase plasma levels- inflammation tests ( PCR, fibrinogen, sedimentation rate)- thyroid hormone levels- blood electrolytes - HBV- HCV- blood lipid profileto establish the possible diagnosis. Regarding your high blood pressure, I would advise to discuss with your attending physician the possibility to make some changes to your actual antihypertensive therapy, or to start therapy if your don't have any. Hope to have been helpful!Best regards, Dr. Iliri