Double Trouble

An elderly patient returned from travels in the Far East with unusual skin discoloration and muscle pain. It soon became clear that more than one condition was rapidly affecting his health. Andy, a clinical laboratory scientist, used analysis, quick thinking and collaboration with the patient's physicians, to help identify a dangerous combination of factors before the patient could be seriously harmed.

Initial blood test results identified that the patient had contracted the rare Hepatitis E virus during his travels. The tests also showed cholesterol-lowering statin drugs in the blood, which the patient was using to treat a recurring heart condition.

However, while performing additional tests, Andy spotted an unusual pattern of results that suggested there might also be a severe muscle problem. Progressing muscle damage was concerning, as the resulting breakdown product in the blood can lead to kidney failure – a potentially life-threatening condition.

Upon Andy's recommendation, the patient was quickly admitted to the hospital. By this time the patient's muscle pain had worsened and he was very weak and unable to stand.

It became apparent that the patient's symptoms were not associated with the Hepatitis E virus, but probably related to a food and drug interaction. Further investigation into his daily lifestyle revealed a recent change in diet to which many people would never pay attention: when the patient returned from vacation, he started having grapefruit regularly at breakfast. An interaction between grapefruit and statin drugs is strongly cautioned in pharmacy handbooks.

Thanks to Andy's careful analysis of the situation, the patient was taken off the statin, and walking normal again within the week.

In this case, there were two different diagnosed conditions with overlapping test abnormalities - a particularly difficult problem for any health care professional to detect. One of the exciting challenges for a lab scientist like Andy is to look for patterns of test results that don’t always fit into the obvious diagnosis.

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