I have lost 15 pounds in 4 weeks My cbc

Patient

Q: I have lost 15 pounds in 4 weeks
My cbc came back as

Wbc 10
Rbc normal
Mcv 94.2 high
Mchc 31.9 low


Electrolyte panel

Everything normal except anion gap says 9.2 low

Rest of cbc all normal

Doctor

A:   Hi.
Thanks for your query.
Read and understood that you have lost 15 pounds in 4 weeks, and for such a weight loss just doing these few blood tests have no role at all.

I would like to know few details before I can really comment upon this:
- Your age and sex (gender) please.
- Any other associated problem like diabetes or any other general illness?
- any history of:
fever
loss of appetite
change in bowel habits
unexplained cough
weakness
or any other complaint which you feel related to or unrelated to the weight loss.

You have to then go for a battery of investigations meant for unexplained weight loss under the care of a Physician who on clinical evaluation can tell better the direction to go.

I hope to get your feedback so that we can discuss further.
Yes, please take this seriously.

Comments / Follow Ups

Patient: 43 male
Pre diabetic
Anxiety over weight loss
Not as hungry
Had fever from sickness everyone in house had
Have had ribbon stool in past but not all the time
Could this be huge pylori or does this seem like leukemia or cancer in body
Doctor: You have correctly read my mind.
Serious illness has to be excluded by appropriate tests.
Consult you Physician and get all the relevant tests done.
I would suggest you the following to start with and the further tests depending upon the clinical picture and the reports of the ones to be done first.
- X-ray chest
Ultrasonography of the abdomen
Upper GI and lower GI endoscopy
Rest of the reports as per the clinical presentation, physical findings and preliminary reports.
Like CT scan, the cancer markers in the blood and so on.

So please get started.

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