Vakul Aren : Welcome to JA. I am Dr. Vakul Aren ,I will help you with your query.The urobilinogen level appears to be slightly elevated,this may occur after a course of antibiotics which disturb the bacterial flora of the intestines.The leucocyte esterase is indicative of a urinary infection,possibly in the kidneys which may be the reason for the flank/back pain as also intestinal disturbance leading to bloating. Your PCP may order a urine culture and antibiotic sensitivity test to look for the best antibiotic for the infection before starting an antibiotic like Cotrimoxozole empirically .Once the infection resolves,the bloating and gas will also settle down.He will switch to the best antibiotic once the culture reports are in.
Customer: none of this being significant to lesion findings on the liver
Vakul Aren : Rarely liver lesions may contribute to elevated urobilnogen levels but they would be higher than the borderline result indicated by you.The severe flank and back pain are highly suggestive of a renal pathology,it would be best to get a ultrasound scan done to rule out any renal stones or obstruction leading to infection in the urine as suggested by the trace of leukocyte esterase.
Vakul Aren : It would help if a ultrasound scan or a CT scan is done to rule out any liver pathology or renal involvement.
Vakul Aren : The leukocyte esterase test is not in any way connected to liver pathology,it just suggest infection in the urinary tract.Liver lesions along with renal infection may occur independent of each other.
Customer: ultra sound was done today - results showed polyp (sp?) in/on gal bladder and 3 lesions on liver _ she indicated if my blood work came back normal that was a good sign otherwise they would need to look into things further which would include a CT scan. Because lesions were foubd on liver - it would be important to take a closer look at that none the less. Mother died at 63 of lung cancer and father died of lung cancer at 58 - both had cancer move to the liver - I think I am just paranoid. I am female, 44. Test results below - feedback pleaseGlucose, UA NEGATIVE NEGATIVE Bilirubin, UA NEGATIVE NEGATIVE mg/dLKetones, UA NEGATIVE NEGATIVE mg/dLSpecific gravity, UA 1.014 1.001 - 1.035 Hemoglobin,ur,ql NEGATIVE NEGATIVE mg/dLpH, UA 6.0 4.5 - 8.0 Protein, UA NEGATIVE NEGATIVE mg/dLUrobilinogen, UA <2.0 0.0 - 2.0 mg/dLNitrite, UA NEGATIVE NEGATIVE mg/dLLEUKOCYTE ESTERASE, UA TRACE NEGATIVE Leu/
Customer: i am happy with results each time I hit excellent it is defaulting to poor service - that is not what i want
Vakul Aren : I would be grateful if you could hit good service /OK service as a negative rating like poor reflects poorly on us.Alternatively,you could send a note to the customer service saying that negative rating is coming up when you hit excellent.thank you.
Vakul Aren : Upon reading the detailed reports,I feel your reports reflect only that you probably have a gall bladder lesion as well as liver lesions.The urinary tract is essentially normal.
Customer: yes absolutely - i am copying our conversation to send along - very very happy with results thus far just waiting your response to my last post and then I will let you go. Thank you Dr. I will certainly follow up with customer service
Vakul Aren : Thank you.
Customer: so i guess i am not understanding - no uti but there is concern regarding the liver leisons
Customer: Glucose, UA NEGATIVE NEGATIVE Bilirubin, UA NEGATIVE NEGATIVE mg/dLKetones, UA NEGATIVE NEGATIVE mg/dLSpecific gravity, UA 1.014 1.001 - 1.035 Hemoglobin,ur,ql NEGATIVE NEGATIVE mg/dLpH, UA 6.0 4.5 - 8.0 Protein, UA NEGATIVE NEGATIVE mg/dLUrobilinogen, UA <2.0 0.0 - 2.0 mg/dLNitrite, UA NEGATIVE NEGATIVE mg/dLLEUKOCYTE ESTERASE, UA TRACE NEGATIVE Leu/
Customer: under dLLEUKOCYTE ESTERASE, UA - the result reads Trace as opposed to negative - is that of concern
Vakul Aren : It may occur trace with inflammation alone.
Customer: can you speak to the liver lesions that were found via ultra sound?
Vakul Aren : Can you give me the details of the report of the ultrasound scan?
Customer: dont have those
Vakul Aren : Without the reports it would not be possible to comment on the liver lesions.
Customer: can they be normal or does this draw concern to have leisons on the liver
Vakul Aren : If lesions were reported in the liver,they would not be normal.