___ [NAME] returned to the oncology clinic today to follow up on her lymphadenopathy, and several studies that were performed recently. One was a bone marrow (aspirate and) biopsy, and this was negative for any malignancy. There was (a lymphocytosis), but flow cytometry did not identify any malignant forms. Fortunately, no evidence of leukemia or lymphoma were identified. At the time the bone marrow was done, her platelet count had dropped significantly to 27,000. It had been over 300,000. The bone marrow showed normal levels of (megakaryocytes) suggesting a peripheral destruction. Blood studies were performed including serum protein electrophoresis, double-stranded DNA, C3, C4, (cardiolipin antibodies), (Smith antigen), RNP, SSA, and SSB. Of these, the only 2 that were abnormal was the C3 and C4. The C3 was at 50. The C4 was at 6.3. I reviewed these results with Dr. ___ [NAME] who feels that this is very suspicious for systemic lupus erythematosus.
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She is going to be seeing Dr. ___ [NAME] in the next couple of weeks. I think we are just about done here, as she does not have a malignancy. However, I am concerned that her platelet count has dropped though drastically. Today I am going to repeat her CBC to see if this is a real finding. If the platelet count remains low then we will need to start prednisone. I have not schedule ___ [NAME] for a return appointment to see me in the future, but I would be happy to see her at any time that it is deemed
She is going to be seeing Dr. ___ [NAME] in the next couple of weeks. I think we are just about done here, as she does not have a malignancy. However, I am concerned that her platelet count has dropped though drastically. Today I am going to repeat her CBC to see if this is a real finding. If the platelet count remains low then we will need to start prednisone. I have not schedule ___ [NAME] for a return appointment to see me in the future, but I would be happy to see her at any time that it is deemed