Gabriel, Andrea Joyce P.

May 16,2024

3-YB-1 IRREG

CASE STUDY

A semen specimen is collected by a 45-year-old man for evaluation of a vasectomy performed 12 weeks
earlier.

1. List any abnormal or discrepant results based on the laboratory results

Abnormal or discrepant in:

- Decreased concentration since it is less than 20 million and should be greater than million/mL,
- Increased leukocytes - greater than 1 million leukocytes per milliliter is associated with
inflammation or infection of the reproductive organs that can lead to infertility.
- And there’s a presence of bacteria.

2. Do any of the results obtained suggest improper specimen collection or laboratory error?

No. The specimen is in proper collection, but since there is a presence of more than 1
million leukocytes indicated with inflammation or infection of the reproductive organs. The
presence of bacteria with increased leukocytes indicates an infection of the male reproductive
organs.

3. After an appropriate time interval, how many sperm should be present in seminal fluid after a
successful vasectomy?

After an appropriate time interval in a successful vasectomy, the sperm present in

seminal fluid is zero. Since a vasectomy is surgical removal of all or part of the vas deferens
for the purpose of male sterilization. And the patient should have zero sperms and undergo
2-3 months testing of sperms.
Gabriel, Andrea Joyce P. May 16,2024

3-YB-1 IRREG

A 39-year-old woman noticed numbness in her left leg and difficulty walking approximately 3
months ago. Since that time, the numbness seems to come and go, along with episodes of dizziness.
More recently, she has experienced numbness on the right side of her face and “blurred” vision in
her right eye that comes and goes. She gets tired easily and often feels unsteady while upright and
walking. She is admitted to the hospital for tests. Cerebrospinal fluid and pertinent blood chemistry
results follow.

1. List any abnormal results

CSF has abnormally high IgG levels. In the CSF, the normal range for IgG level is 0-4.5.
The result has an unusually high IgG level of 12.4 mg/dL. The differential cell count in CSF is
slightly abnormal, even when the total cell count falls within the normal range of 0–5 cells. The
normal range for the lymphocyte count is 60% to 70%, the CSF lab findings show that the
lymphocyte 75% shows abnormality. A 30%–40% monocyte count is normal range, the CSF lab
findings show that the monocyte count is 24% which shows abnormality. And few or rare are
the neutrophils which show abnormality.
Gabriel, Andrea Joyce P. May 16,2024

3-YB-1 IRREG

2. Why is the CSF/serum albumin index a good indicator of the integrity of the blood-brain
barrier?
Serum Albumin is an ideal for evaluating BBB function since it is generated peripherally, does
not readily diffuse across an intact BBB, and is not catabolized within the central nervous
system.

3. Suggest a diagnosis that is consistent with the results obtained and the patient history
An elevated level could be a sign of multiple sclerosis, which causes the CNS's
immunocompetent cells to express a higher percentage of IgG. Additionally, the patient's
indications and symptoms correspond with what MedlinePlus said.
●Exhaustion and shakiness when continuing to walk.
●A blurry vision in the night eye
●Periods of vertigo and numbness in the left leg and right side of the face.
Considering these signs, we can make assumptions that a patient might have Multiple Sclerosis
(MS). Numbness, visual abnormalities, weakness, and exhaustion are just a few of the
neurological symptoms that can be brought on by this chronic inflammatory demyelinating
illness of the central nervous system. Additionally, it described symptoms such as intermittent
numbness and dizziness.

4. Based on the diagnosis chosen, state two additional chemical tests that could be performed
to confirm this diagnosis, and indicate the results expected.

A. Oligoclonal band (OCB) analysis in CSF: Patients with MS may exhibit aberrant
immunoglobulin bands in their asE.

B. Myelin basic protein (MBP) level in CSF: Myelin breakdowns result in an increase in MBP
levels in cSF. Elevated levels of MBP in the CSF would support the MS diagnosis.

Results:

OCB analysis: indicates that there is OCBI present in the coE.

MBP level: A higher MBP concentration in the CSF.