Table 1.
Outpatient investigations
| Date (2017) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Parameter | May 23 | June 12 | July 10 | August 7 | August 21 | August 24 | September 20 | October 17 | Normal range |
| White cell count, cell/mm3 | 1800 | – | 2000 | 2500 | 2300 | 2100 | 6800 | 8000 | 4500–11,000 |
| Neutrophils | 414 | – | 420 | 1000 | 529 | 483 | 4094 | 4368 | 1570–7700 |
| Lymphocytes | 1044 | – | 1440 | 1225 | 1495 | 1386 | 2020 | 2816 | 900–3850 |
| Monocytes | 144 | – | 120 | 125 | 230 | 210 | 558 | 696 | 72–1100 |
| Eosinophils | 54 | – | 20 | 100 | 23 | 21 | 82 | 64 | 90–550 |
| Hemoglobin, gm/dl | 11.4 | – | 12.5 | 11.7 | 12 | 12 | 13 | 14.2 | 12–16 |
| Platelet count, per mm3 | 152,000 | – | 146,000 | 151,400 | 128,000 | 139,000 | 178,000 | 192,000 | 150,000–450,000 |
| Mean corpuscular volume, mm3 | 80.38 | – | 80.92 | 90 | 82.7 | 88.9 | 86.06 | 86.7 | 80–100 |
| ESR, mm/h | – | – | 65 | 67 | – | 54 | 31 | 20 | < 20 |
| RF, IU/ml | – | – | 211.3 | – | – | – | – | – | < 30 |
| Anti-CCP antibodies, U/ml | – | – | 274 | – | – | – | – | – | < 17 |
| ANA (Hep 2 cell) | – | Pattern Homogeneous nuclear pattern 1:80 dilution Chromosome metaphase plate reagent |
– | – | – | – | – | – | Non-reactive |
| ELISA chikungunya IgG | – | – | – | – | Reactive | – | – | – | Non-reactive |
| Lactate dehydrogenase U/l | – | 531 | – | – | – | – | – | – | 313–414 |
| Anti-HIV 1 and 2 | – | Non-reactive | – | – | – | – | – | – | Non-reactive |
| Anti-HTLV 1 and 2 | – | Non-reactive | – | – | – | – | – | – | Non-reactive |
| DAS28-ESR | – | – | – | – | 7.39 | – | 2.54 | 2.2 | Remission < 2.6 |
| CDAI | – | – | – | – | 72 | – | 2 | 2 | Remission 0.0–2.8 |
| Bone marrow biopsy | June 1 | ||||||||
| Erythrocyte series: normocellular, nomomaturative, and normoblastic Granulocytic series: discretely hypocellular, with moderate maturative delay. Myoblasts: 6.6%; Promyelocytes: 8.8% Myelocytes: 3%; Rods: 19%; Segmented: 2.2%; Eosinophilic cells: 5%; Signs of dysgranulocitopoiesis Lymphomonoplasmocytic series: lymphocytes: 22%; Plasma cells: 3.6% Megalacariocytic series: normocellular | |||||||||
| Bone marrow aspirate | July 25 | ||||||||
| Normocellular bone marrow, with discreet hypocellularity in the neutrophilic lineage with important maturative delay, discrete increase of blasts and slight eosinophilia | |||||||||
| Abdominal ultrasound | June 20 | ||||||||
| Splenomegaly (uniplanar splenic index = 72.6) | 19.8 ± 12.3 | ||||||||