APR-04-2001 20:13 RCM P.001

APR-04-2001 20:13 RCM P.001 • Tcahn School of Medicine at Mount Sinai Department of Clinical linnhnology, 5 East se SSreet, 11th Floor. New York, NY 10029 Shradha Aganval.M.D.; Pavia Susse,M.D.; Beth Eve Com.M.D.; Charlotte CtmnInaharn-Rundles,M.D.Ph.D.: Elena Resnic:k,M.D. Gate: ‘;'! Phon Urgent. From: Cynthia Medina, RMA CC: C Fc• Review O Please Comment ❑ Please Reply C Please Recycle • Comments; This document contains confidential health informadon that I legally privileged. This infomnation a on:), for the use of the Individual or entity named above. The autheriZed redolent of this information is prohlbited from discloshg his information to any other ea -ty unless required to do 90 bY law Or regtiedaa and 6 required to destroy the information after its stated need Is, tunted, V you are NOT the intended thodgent, you are hereby notified that any disdostre, reeving, distribution, or anion taken in reliance on the content of these documents is strictly prohibited. If you have received thtS Information in error; please notify the sender Itnenedtey and arrange for the return or destruction of these documents. Thank you. 12/30/2013 11:11AM (GMT-05:00) EFTA01104649 APR-04-2001 20:13 HCM P.002 JAMUL 1- ..7/ 41/1.) Jeffrey Epstein izisi2013 4:03 PM Telephone MRN: 7206913 poscription. 60 year old male Pregicisc Paula J Busse, MD Oepa'Inent: Clinical Immunology Patient Information Patient Information Patent Name Sex DOB Epstein, Jeffrey Male 1/20/1953 Patient Demographics Telephone Contact Summary Call Information SSN (Home) (Mobile) Date S Time Provider Deportment Cenutr 12/19/2013 4:03 PM Paula J auSse. MD Fpa Clinical Immunology None Reason for Call Test results Call Documentation Paula J Busse, MD 12/19/2013 4:09 PM Signed Spoke with Dr. Shimony (91 7-922-7 391). 1) I explained that the patient had mildly elevated IgE to peanut (0.44) and sesame seed (0.36), but he tolerates these foods so I would not recommend avoidance. If there is a concern, he can RTC for skin prick testing to these foods. 2) We also discussed that his TSH, CBC, CMP, C4 WNL (therefore not likely HAE-also since responded to corticosteroid treatment). 3) Patient was given Epipen Rx and Rx for prednisone to take for emergency use 4) That I recommended to the patient to resume his lipid medications Other notes for chart: 1)IgE detectable to some environmental allergens—cat dog, tree, grass, ragweed—not likely to be etiology of swelling 2) SPEP WNL I LEFT A MESSAGE ON THE PATIENTS CELL PHONE WHICH WAS PROVIDED IN EPIC THAT LAB RESULTS WERE BACK, BUT NO CONCERNING VALUES--DID NOT LEAVE SPECIFIC INFORMATION. Tryptase, ANA pending Allergies as of 12/19/2013 Reviewed C. 12/18/2013 By Paula J Busse, MD Epstein, Jeffrey (MR # 7206913) Printed by Cynthia Medina (10714] at 12/30/13 10:47 A... Page 1 of 2 12/30/2013 11:11AM (GMT-05:00) EFTA01104650 APR-04-2001 20:14 HCM d••• JU• ay./' ..... ••••“' P.003 _ _m. Results: ASTHMA PROFILE Abnormal Status. Final result 12/1912013 11:54 AM Component Value RangoilUnits CL HERBARUM IGE <0.35 c035klUil ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 k/O/L Antibody level low 0.71 to 3.5 kIO/L Antibody level moderate 3.51 to 17.5 kIO/L Antibody level high kIV/L Antibody level very high ASP,FUNMGATUSIGE <0.35 <0.35kalk ALLERGEN SPECIFIC REFERENCE RANGE 0.35 k/U/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high MUCOR RACEMOSUS IGE <0.35 <0.35 ktU'L ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectabla level 0.35 to 0.70 kItt/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 kIV/L Antibody level high >17.5 kIU/L Antibody level very high C. ABLICANA ICE 40.35 <0.35 kIU/L ALLERGEN SPECIFIC REFERENCE RANGE <0.35 0.35 to 0.70 0.71 to 3.5 3.51 to 17.5 >17.5 ALT.TENUMIGE kIO/L Antibody absent or at undetectable level k/U/L Antibody level low kItI/L Antibody level moderate kIU/L Antibody level high kIV/L Antibody level very high <0.35 <0.351dU/L ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 kI0/1. Antibody level high >17.5 kIV/L Antibody level very high DeR.PTERONYSSINUSIGE <0.35 <0.361dUA. ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIV/L Antibody absent o: at undetectable level 0.25 to 0.70 kIU/L Antibody level low 13.71 to 3.5 kIll/L Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high DER. FEMME IGE <0.35 <0.35 kitEL ALLERGEN SPECIFIC REFERENCE RANGE <0.35 0.35 to 0.70 0.71 to 3.5 3.51 to 17.5 kitt/L Antibody absent or at undetectable level kIV/L Antibody level low kItI/L Antibody level moderate kIU/L Antibody level high s7xus Fna F:nal Final Final Final Final Final Epstein, Jeffrey (MR # 7206913) Printed by Cynthia Medina (107I4] at 12;30/13 10:47 A. Page 1 of 11 12/30/2013 11:11AM (GMT-05:00) EFTA01104651 APE-04-2001 20:14 11O4 vti.. ;v. [uIJ.a IU, 'Von w P.004 catur.::.; r....i4t/l3 >17.5 kIU/L Antibody level very high CATDANDERKNE 0.70 (H) <35 kILI/L ALLERGEN SPECIFIC REFERENCE RANGE <0.35 klU/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 klU/L Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high DOG DANDER me 1.06 (H) <0.35kitfiL ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kI0/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 kItili Antibody level high 517.5 kIU/L Antibody level very high BLATELLAGERMANICAIGE <0.35 <0.35O1EL ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 RIU/L Antibody level high >17.5 kiii/L Antibody level very high 0/11(0AMITE)IGE 0.96 (H) <0.35kIWL ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIVI, Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level LOW 0.71 to 3.5 MIA Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high TIMOTHY IGE 0.78 (H) <025kKHL ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.11 to 3.5 kiU/1. Antibody level moderate 3.51 to 17.5 KIU/L Antibody level high >17.5 kIU/L Antibody level very high COM.RADANEEIME 3.93(H) <0.35 k1UlL ALLERGEN SPECIFIC REFERENCE RANGE <0.35 0.35 to 0.70 0.71 to 3.5 3.51 to 17.5 >17.5 IG E QUANT Fnal Final Final Final Final Final ki0/1, Antibody absent or at undetectable level kIU/L Antibody level low kIV/L Antibody level moderate kIU/L Antibody level high kiU/L Antibody level very high 45800 Final Results: CBC+PLT+DIFF Lab Inquiry View Compete Results Status: Final result 12118/2013 6:01 PM Compeiont Value Range & Units S 3tus WHITE BLOOD CELL 8.7 4.5 -11.0 x10 3/uL Final RED BLOOD CELL 4.91 4.50 - 6.00 x10 Slut. Final HEMOGLOBIN 14.5 13.9 - 16.3 GA31 Final Epstein, Jeffrey (MR # 7206913) Primed by Cynthia Medina :1C714) at 12130/13 10:47 A... Page 2 of 11 12/30/2013 11:11AM (GMT -05:00) EFTA01104652 APR-04-2001 20:15 RCM P.005 HEMATOCRIT 42.4 42.0 - 52.0 % Final MEAN CORP. VOLUME 86.3 80.0 - 98.0 FL Final MEAN CORP. HGB 29.5 27.0 - 32.0 PG Final MEAN CORP. HGB CONC. 34.2 32.0 35.0 G/DL Final RED DISTRIB. WIDTH 13.5 11.5 - 15.0% Final PLATELET 285 150 -450 x10 3/uL Final MEAN PLT VOLUME 7.8 7.4 - 12.0 FL Final NEUTROPHIL % 64.2 40.0 - 78.0 % Final LYMPHOCYTE % 26.5 15,0 - 50.0 % Final MONOCYTE % 4.5 2.0 -11.0 % Final EOSINOPHIL % 4.2 0.0 - 5.0 % Final BASOPHIL % 0.6 0.0 - 1.0 % Final NEUTROPHIL 5.6 1.9 - 8.0 x10 3/uL Final LYMPHOCYTE it 2.3 1.0 - 4.5 x10 3/uL Final MONOCYTEN 0.4 0.2 - 1.0 x10 3/uL Final EOSINOPHIL # 0.4 0.0 - 0.6 x10 3/uL Final BASOPHIL 0.1 0.0 - 0.2 x10 3/uL Final Results: COMPREHENSIVE METABOLIC PANEL Lab Inquiry yiew_Comalete Results Stags: Final result 12118/2013 8:38 PM Component value Range&Units S,atus ALBUMIN 4.3 3.5.4.9 G/DL Final BILIRUBIN TOTAL 0.5 0.1 - 1.2 MG/DL Fuel CALCIUM 9.6 8.5 -10.5 MG/DL Final CHLORIDE 103 96 - 108 MEO/L Final CREATININE 1.01 0.70 -1.40 MG/OL Final GLUCOSE 113 65 -139 MG/DL Final MN-MST:NG 65-139 mg/dt FASTING 55 - 99 mg/d1. ALK.PHOSPHATASE 58 30 -110 U/l. Final POTASSIUM 4.0 3.5 • 5.0 MEO/L Final PROTEIN TOTAL 7.0 6.0 - 8.3 G/DL Final SODIUM 142 135. 145 MEO/L Final MT (SOOT) 18 1 -60 UR_ Final UREA NITROGEN 21 10 -30 MG/DL Final CO2 TOTAL 23.4 22.0 - 32.0 MEO/L Final ALT(SGPT) 19 1 .53 LPL Final EGFR AFRICAN AM >60.00 rnItmin/1.73m Final The National Kidney Diseaso Education Program automatically report estimated GFR when serum Glomarular Filtration. Rate (GFR) estimate has Americans using ICMS traceable MORO equation. applicable in pediatric patients less than 18 recommended for determining drug dosing. Use determine drug doses. EGFR NON-AFR AM >60.00 ml/min/1.73m Final This Glomerular Filtration Rate (GFR) estimate has been calculated for Non-African Americans using IOt4S traceable MORD equation. :his equation is not applicable in pediatric patients less than 19 years of age. Staging of Chronic Kidney Disease (CKD) GFR 30-59 -CX0 Stage 3 (Moderate) GFR 15-29 4CKD Stage 4 (Severe) GFR <15 4CKD Stage 5 (Kidney Failure) encourages laboratories to creatinine is ordered. Thi9 been calculated for African This equation is not years of age. MORD is not Cockcroft -Gault equation to Epstein, Jeffrey (MR # 7206913) Printed by Cynthia Medina [107141 at 12/30/13 10:47 A... Page 3 of 11 12/30/2013 11:11AM (GMT-05:00) EFTA01104653 APR-04-2001 20:15 RCM .." P.006 1.411. 1/411 __.c. ZVI NORD is not recommended for determining drug dosing. Use Coolccroft-Gault equation to determine drug doses. Results: ANA SCREEN Abnormal Lab Inquiry View Complete Results Status: Final result 12/20/2013 1:43 AM Component VaJs Range t.l2nils Status ANA SCREEN (1:40) Positive (A) Negative Final Lab inouiry View Complete Result/ Results: ANTI-DNA, DOUBLE-STRANDED, QUALITATIVE, Status: Final result SERUM 12/19/2013 3:01 PM Component value Range & Units Status ANTI DNA DS• QUAL NEGATIVE NEGATIVE Final 1_Omi:wiry Results: TSH WI FREE T4 REFLEX View Complete IReSultS Status: Final result 12/18/2013 7:11 PM Component Value Range & Units Status TSH W/FREE T4 RELEY 1.90 0.34 - 5.60 ulU/MI Final Reference Ranges: Age: Female: Male; 1-25 Cays 1.5-6.5 0.1-9.8 1-24 months 1.6-5.7 0.7-5.9 9-10 years 0.9-4.0 1.0-3.7 11-14 years 0.7-3.4 0.8-3.9 15-17 years 0.6-3.7 0.7-2.8 18-99 years 0.34-5.60 0.34-5.60 Results: TRYPTASE Lab Inquiry View Complete Rol)* Status: Final result 12/21/2013 3:34 AM Component TRYPTASE Valuo Range & Units Status 4.6 0.4 -10.9 ug/L Final Performed by AAUP Laboratories, 500 Chipeta Way, SLC,UT 84108 800-522-2787 www.aruplab.coN, Jerry W. Russ0(19. MD - Lab. Director PLEASE NOTE: TEST NOW BEING PERFORMED AT AR0P LABS. REFERENCE RANGES MAY HAVE CHANGED. Results: SMITH ANTIBODY Lab lnouiry View Complete Resuitq Stetus: Final result 12/20/2013 2:44 PM Component Value Range. & Units Status SMITH ANTIBODY 1 0.40AlMnL Final INTERPRETIVE INFORMATION; SMITH (ENA) Ab, IgG 29 All/mL or Less Negative 30 - 40 AC/mL Equivocal 41 AU/mL or Greater Positive Smith antibody is very specific for systemic lupus erythematosus (SLE) but only occurs in 30-35t of SLE cases. The presence of antibodies to Smith is often associated Epstein, Jeffrey (MR # 7206913) Printed by Cynthia Medina [107141 at 12/30/13 I0:47 A... Page 4 of 11 12/30/2013 11:11AM (GMT-05:00) EFTA01104654 APR-04-2001 20:15 HCM IJeC- LU r r: • itrinr iLVV71J) P.007 with renal disease. Performed by ARUP Laboratories, 500 Chipeta Way, SLC,UT 84108 800-522-2787 www.aruplab.com, Jerry W. HuSS0ng, MD - Lab. Director PLEASE NOTE: TEST NOW BEING PERFORMED AT ARUP LABS, REFERENCE RANGES MAY HAVE CHANGED. Results: RNP ANTIBODY Lab Inouiry View Complete Results Status: Final result 12/20/2013 2:42 PM Component Value RNP ANTIBODY 0 INTERPRETIVE INFORMATION: Ribonucleic & Units 0 - 40 AllimL Protein. (EIA) Antibody, 29 AU/ml, or Less Negative 30 - 40 AU/ml, EquivocaL 41 AU/mL or Greater Positive RNP antibody is seen in 95-100 percent of mixed connective tissue disease and is considered specific for this syndrome if other antibodies are negative; RNP is also present in 20-30 percent of systemic lupus erythematosus and 15-25 percent of progressive systemic sclerosis. RNP antigens also contain epitopes that are immunologically identical to free Smith antigens, therefore, the Smith antibody response must be considered when interpreting RN? results. Performed by ARUP Laboratories, 500 Chipeta Way, SLC,UT 84108 800-522-2787 www.aruplab.com, Jerry W. Hussong, MD - Lab. Director PLEASE NOTE: TEST NOW BEING PERFORMED AT ARUP LABS, REFERENCE RANGES MAY HAVE CHANGED. Lab Inpuiry Results: NORTH EAST URD PROFILE Abnormal Status Final :qG View Complete Results Siat.is: Final result 12119/2013 11:54AM Component Valoo Rime & Units ELM IGE 0.93 (H) <0.35 klU/L ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 klU/L Antibody level moderate 3.51 to 17.5 kIu/L Antibody level high >17.5 kIU/L Antibody level very high MAPLE IGE 0.93 (H) <0.35 MU& ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIV/I. Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level .ow 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high BERMUDA GRASS IGE 1.11 (H) <0.35 klU/L ALLERGEN SPECIFIC REFERENCE RANGE Status Final Final Final Epstein, Jeffrey (MR # 7206913) Printed by Cynthia Medina [107141 at 12/30/13 10:47 A... Page 5 of 11 12/30/2013 11:11AM (GMT -05:00) EFTA01104655 APR-04-2001 20:16 RCM P.008 <0.35 k/U/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody 1eve. moderate 3.51 to 17.5 klU/L Antibody level high >17.5 kIU/L Antibody level very high GOCISEFCH3TIGE 0.84 (H) <0.35 kIU/L ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent o: at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 k/U/L Antibody level moderate 3.5: to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high Results: ALMOND-F20 Final ) ab Inquiry View Complete Results Status: Final result 12/19/201311:54 AM Component Value Rarge & Units Statt.s • ALMOND IGE <0.35 <0.35 klU/L Final ALLERGEN SPECIFIC REFERENCE RANGE <C.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 k/U/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 klU/L Antibody level high >17.5 kIU/L Antibody level very high Results: BRAZIL NUT Lab inquiry View CompLete Results Status: Final result 12,t1 9/2013 11:54AM Component Value Range & Units Status BRAZIL NUT IGE <0.35 <0.35 klU/L Final ALLERGEN SPECIFIC REFERENCE RANGE <0.35 k/U/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody /eve: low 0.71 to 3.5 kI0/1, Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high Results: CASHEW NUT Lab Inquiry View Complete Results Status: Final result 12/1912013 11:54 AM Component Value Range &Unit: Status CASHEW NUT IGE <0.35 <0.35 kIU/L Final ALLERGEN SPECIFIC REFERENCE RANGF. <0.35 kI0/1 Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 ;am Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 ki0/1. Antibody level very high Results: CRAB Lab inouLry View Complete Results Status: Final result 12/19/2013 11:54 AM Component Vero Range & Units Staves CRAB IGE <0.35 <0.35 kW/ final Epstein, Jeffrey (MR # 72069I3) Printed by Cynthia Medina [10714] at 12/30/13 10:47 A... Page 6 of 11 12/30/2013 11:11AM (GMT-05:00) EFTA01104656 APR-04-2001 20:16 HCM A ...C. L.- [-V 1 J P.009 ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 klv/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 k/U/L Antibody level high >17.5 klu/L Antibody level very high Results: EGG WHITE F.1 Lab Inquiry View Complete Results Status: Final result 12/19/2013 11:54 AM Component Value RengeAllnits Status EGGNMEIGE <025 <0.35 kIU/L Final ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/l Antibody level moderate 3.51 to 17.5 kltlL Antibody level high >17.5 kIU/L Antibody level very high jabIns:wiry Results: WALNUT, BLACK FOOD-FM View Complete Results Status: Final result 12/19/2013 11:54AM Component Value Range & Units Scotus WALNUT IGE <0.35 <0.35 MU/1 Final ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at Undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody love: very high Results: TUNA Lab Inquiry View Complete Results Statist Final result 12/19/2013 11:54AM Component Value Renpa&Unfts Status TUNA IGE <0.35 <0.35 kW& Final ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/7.. Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high Lab [MON Results: SUNFLOWER SEED view Complete Results Status: Final result 12119/2013 11:54 AM Compontmt value Range a Units Status SUNFLOWER SEED IGE <0.35 <0.35 KUL Final ALLERGEN SPECIFIC REFERENCE RANGE <0.35 k/U/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 k/U/L Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high Epstein, Jeffrey (MR it 7206913) Printed by Cynthia Medina [10714] at 12/30/13 10:47 A... Page 7 of 11 12/30/2013 11:11AM (GMT-05:00) EFTA01104657 APR-04-2001 20:17 HCM IVIJII4.)JnAM ILVV7SJJ P.010 cricou - - „ Results: SHRIMP ab Inquiry View Complete Results Status: Final result 12/19/2013 11:54 AM Component Value Range 8 Units SHRIMP IGE <0.35 <0.35 MU/ ALLERGEN SPECIFIC REFERENCE RANGE <0.3$ kIU/L Antibody absent or at undetectable level 0.35 to 0.70 kiU/L Antibody level low 0.71 to 3.5 kIe/L Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high Lab Inquiry Status Final View Comolete Resulta Results: SESAME SEED Ststus: Final result Abnormal 12119/2013 11;54 AM Component Value SESAME SEED IGE 0.36 (H) ALLERGEN SPECIFIC REFERENCE RANGE Range & Units <0.35 klU/L <0.35 kill/1. Antibody absent or at undetectable level 0.3$ to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 ktu/L Antibody level high >17.5 kIU/1 Antibody. level very high Results: PISTACHIO NUT Status Final lab Inquiry View Complete Results Slalus: Final result 12/19/2013 11:54 AM Component Value Remo & Units PISTACHIO NUT IGE <0.35 <0.35 klU/L ALLERGEN SPECIFIC REFERENCE: RANGE <0.35 kIUFL Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 kIU/L Antibody level high >17.5 kIU/L Antibody level very high Labinaufry Results: PINE (PINON) NUT Status Final View Complete Resuiti 5tna:s• Final result 12/21/2013 4:24 PM Component Velum Range& Units PINE (PINON) NUT <0.10 <=0.34 WA. INTERPRETIVE INFORMATION: Allergen, Food, Pine (Pinon) Nut Test developed and characteristics determined by ARC? Laboratories. See Compliance Statement A: aruplab.com/CS Performed by ARUP Laboratories, 500 Chipeta Way, SLC,OT 84108 800-522-2787 www.aruplab.com, Jerry W. HwaSOng, MD - Lab. Director PLEASE NOTE: TEST NOW BEING FERFORmED AT ARUP LABS, REFERENCE RANGES MAY HAVE CHANGEC. ab Inouitv Status Final View Complete Resultt Epstein, Jeffrey (MR # 7206913) Printed by Cynthia Medina [10714] at 12/30/13 10:47 A... Page 8 of 11 12/30/2013 11:11AM (GMT-05:00) EFTA01104658 APR-04-2001 20:17 HCM 4ti.)1.% iVIXTIU./JmNff /1ObY15) P.011 encoc.../...1.:e: IL: Results: PECAN NUT 5lait.s: Final result 12/1912013 11:54 AM Component Value Range & Units PECAN NUT IGE <0.35 <0.35 klUA. ALLERGEN SPECIFIC REFERENCE RANGE <0.35 k1U/L Antibody absent or at undetectable level Status Final 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 17.5 k1U/L Antibody level high >17.5 kIU/L Antibody level very high Lablnouiry View Complete Result* Results: PEANUT Status: Final result Abnormal 12119/2013 11:54AM Component vaile Range & Units Sates PEANUT IGE 0.44 (H) <0.35 IdU/L Fine' ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kIU/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.7: to 3.5 k13/.. Antibody level moderate 3.51 to 17.5 SIU/L Antibody level high >17.5 kltl/L Antibody level very high Lablnou#y Results: ESTROGENS, TOTAL View Complete Results Stotss Final result 12/22/2013 3:32 PM Component Vnkie ESTRADIOLBYTIOS 14.9 REFERENCE INTERVAL: Estradiol by TMS Range & Units pg/mL Access complete set of age- and/or gender -specific reference intervals for this test in the ARUP Laboratory Test Directory (aruplah.com). Test developed and characteristics determined by AAUP Laboratories. See Compliance Statement a: aruplab.com/CS PLEASE NOTE: TEST NOW BEING PERFORMED AT AAUP LABS. REFERENCE RANGES MAY HAVE CHANGED. ESTRONE 30.2 og/mt. REFERENCE INTERVAL: Estrone by EMS Access complete set of age- and/or gender -specific reference intervals for this test in the ARUP Laboratory Test DireCtcry (aruplab.Com). Test developed and characteristics determined by ARUP Laboratories. See Compliance Statement B: aruplab.com/CS PLEASE NOTE: TEST NOB BEING PERFORMED AT ARUP LABS, REFERENCE RANGES MAY HAVE CHANGED. ESTROGENS TOTAL 45.1 pg/mL CALCULATION Reference interval of estrogens in serum in adults. S:gId$ Final Final Final Epstein, Jeffrey (MR # 7206913) Printed by Cynthia Medina [10714] at 12130/13 10:47 A... Page 9 of 11 12/30/2013 11:11AM (GMT-05:00) EFTA01104659 APR-04-2001 20:18 HCM P.012 ' '14 7206913) britou.!. — 1. .. it.113 Males: Estrone (pg/mi) Men 18 yrs and older 9-36 REFERENCE INTERVAL: Estrogens Estradiol Total Estrogens (og/m1) lin/r.1) 10-42 19-69 Total Calculation Access complete set of age- and/Or gendor-specific reference intervals for this test in the ARUP Laboratory Test Directory (aroplab.cort). Performed by AAUP Laboratories, 500 Chipeta Way, SLC,UT 84108800-S22-2787 www.aruplab.e0m, Jerry W. Hussong, MD - Lab. Director PLEASE NOTE: TEST NOW BEING PERFORMED AT ARUP LABS, REFERENCE RANGES MAY HAVE CHANGED. Lab Inquiry Results: PROTEIN EP, SERUM View Complete Results Status: Final result 12/19/2013 11:13 AM Component Value Range & Umts PROTEIN TOTAL 6.9 6.0 - 8.3 G/DL PROTEIN TOTAL 6.9 6.0 - 8 3 G/DL PROTEIN ELECTRO See Comment NO MONOCLONAL PROTEIN SEEN IN THE GAMMA REG:0N. ALBUMIN, ELP 4.19 ALPHA 1 GLOB 0.28 ALPHA 2 GLOB 032 BETA GLOB 0.81 GAMMA GLOB 0.90 A/G RATIO 1.54 M-SPIKE % 0.00 PA-SPIKE G/DL 0.00 Results: IMMUNOFIX PANEL-SERUM 3.50 - 5.70 G/O1 0.10 - 0.40 G/Cil. 0.40 - 1.10 G/D1. 0.50 - 1.20 G/OL 0.60 -1.60 G/DL g/dl hes Inquiry Status Final Final Final Final Final Final Final Final Final Final Final View Complete Result4 Status: Final result 12/20/2013 9:28 AM Component Value IG G QUANT 879 IG A QUANT 219 IG M QUANT 48 IMMUNORKATION SERUM SEE BELOW No abnormalities seen. Results: COMPLEMENT C4 Range & Units 700 - 1600 MG/DL 70 - 400 MG/DL 40 - 230 MG/DL Status Fatal Final Final Final Lab Inouiry View Complete Result2 tita:us: Final result 12/19/2013 1:09 PM Component COMPLEMENT C4 Value 31 Results: PROTEIN EP, SERUM Rang3 & Units 10 - 40 MG/DL Lab Inquiry States Final View Complete Results Status: Preliminary result 12/18/2013 6:38 PM Component Value PROTEIN TOTAL 7.0 Results: BIRCH Range & Units 6.0 - 8.3 G/DL Lab Inquiry Status: In process Status Final View_Complete Results Epstein, Jeffrey (MR # 7206913) Printed by Cynthia Medina [10714] at 12/30/13 10:47... Page 10 of 11 12/30/2013 11:11AM (GMT-05:00) EFTA01104660 APR-04-2001 20:18 HCM oc.• "1/47• Je C.1 • de, Atrty tint\ n4 7206913) P.013 .. 12/18/2013 6:3S PM Results: BIRCH Abnormal View Complete Results Status Final result 12/20/201312:13 PM Component VarJe. Range 3 Units BIRCH IGE 0.78 (H) ‘0.35 ALLERGEN SPECIFIC REFERENCE RANGE <0.35 kiU/L Antibody absent or at undetectable level 0.35 to 0.70 kIU/L Antibody level low 0.71 to 3.5 kIU/L Antibody level moderate 3.51 to 1/.5 klU/L Antibody level high >17.5 kIO/L Antibody level very high lahlnoUirV Results: ALLERGEN, INTERPRETATION States Final View Complete Aesult6 Status: In process 12/21/2013 4:32 PM View Complete Results Status: Final result 12/21/2013 4:32 PM Results: ALLERGEN, INTERPRETATION Component ALLERGEN, INTERPRETATION: See Note Comment: REFERENCE INTERVAL: Allergen, :nterpretation Less than 0.10 kU/L No significant level detected 0.10-0.34 kU/L Clinical relevance undetermined 0.35-0.70 kU/L Low 0.71-3.50 kU/L Moderate 3.51-17.50 kU/L High 17.51 kU/L or Greater Very High Allergen results cf 0.10-0.34 kU/L are intended for specialist use as the clinical relevance is undetermined. Even though increasing ranges are reflective of increasing concentrations of allergen -specific IgE, these concentrations nay not Correlate with the degree of clinical response or skin testing results when challenged with a specific allergen. The correlation of allergy laboratory results with clinical history and in vivo reactivity to specific allergens is essential. A negative test may not rule out clinical allergy or even anaphylaxis. Performed by ARUP Laboratories, 500 chipeta Way, SLCIUT 84108 800-522-2787 www.aruplab.com, Jerry W. Hussong, MO - Lab. Director PLEASE NOTE: TEST NOW BEING PERFORMED AT ARUP LASS. REFERENCE RANGES MAY HAVE CHANGED. Lasinouiry View Complete Results Epstein, Jeffrey (MR # 7206913) Printed by Cynthia Medina [10714] at 12/30/13 10:47... Page 11 of 11 12/30/2013 11:11AM (GMT-05:00) EFTA01104661