Kismet has been losing weight over the last few months (1.2 lbs since April).  She does not vomit and not having diarrhea.  No decrease in appetite – actually acting more hungry.  She is polydipsic and she has been incontinent for at least 6 months and has been on DES.  PE is overall unremarkable, but she has lost some paraspinal musculature.  Her recent blood work showed an albumin of 1.5. Her white blood count is 22,ooo with a neutrophilia, monocytosis and lack of lymphopenia.  Na:K was 27 with Na 144, K 5.4. &nbs

Kismet has been losing weight over the last few months (1.2 lbs since April).  She does not vomit and not having diarrhea.  No decrease in appetite – actually acting more hungry.  She is polydipsic and she has been incontinent for at least 6 months and has been on DES.  PE is overall unremarkable, but she has lost some paraspinal musculature.  Her recent blood work showed an albumin of 1.5. Her white blood count is 22,ooo with a neutrophilia, monocytosis and lack of lymphopenia.  Na:K was 27 with Na 144, K 5.4.  T4 was WNL 1.7 w/ TSH elevated at 2.2 (0.05-0.42).  SpG 1.025 w/ 1+ protein and an inactive sediment.  I’m suspecting lymphangectasia.  TX GI panel and UPC pending.