Odynophagia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Patient with odynophagia will need blood chemistry and cytology according to the supporting history and examination to rule out causes of pain in swallowing.

Laboratory Findings

Following are relevant laboratory investigations to approach a case of odynophagia:

Base Lines:

• CBC
• ESR
• CRP

Specific tests ;

Cardiovascular	Mediastinitis	Fluid tap and C & S
Chemical / poisoning	Botulism, Chemical burns	Toxicology and Botulism ELISA
Dermatologic	Scleroderma	Antitopoisomerase-1 or Anti-Scl-70 antibodies
Drug Side Effect	ibandronate, Stevens-Johnson Syndrome	ANA profile and drug levels
Ear Nose Throat	Cricopharyngeal spasm, Epiglottitis, Glossitis, Goiter, Laryngitis,  Oral ulcers Stomatitis,  Herpangina, Retropharyngeal abscess Xerostomia	Blood culture, viral assay, throat culture, TSH
Endocrine	Diabetic neuropathy, Hyperthyroidism, Hypothyroidism, Riedel thyroiditis	HBA1C, TSH, Blood cultures
Gastroenterologic	Esophagitis, Gastritis, Intramural pseudodiverticulosis, Schatzki ring, Myoneurogastrointestinal encephalopathy syndrome, Crohn's disease, Eosinophilic esophagitis	Electrolytes, ANA profile, stool H.pylori test
Genetic	Opitz-Frias syndrome	Genetic testing PCR
Hematologic	Agranulocytosis, Lymphadenopathy	Vit B12, RBC folate, Bone marrow microscopy
Infectious Disease	Abscesses, Acute pharyngitis, Adenoiditis, Candidiasis, Chagas Disease, Cytomegalovirus, Diphtheria, Esophageal moniliasis, Flu, Herpangina, Herpes simplex virus (HSV),  Herpes stomatitis, HIV/AIDS, Mononucleosis, Mumps, Oral candidiasis, Paracoccidioidomycosis, Pharyngitis, Poliomyelitis, Rabies, Reflux esophagitis, Respiratory tract infections,  Retropharyngeal abscess, Scarlet Fever, Tetanus, Tonsillar abscess, Typhoid fever	Viral markers, Blood C & S, Throat and sputum DR & CS,Fungal markers
Musculoskeletal / Ortho	Schatzki ring, Dermatomyositis, Myasthenia Gravis	anti–acetylcholine receptor (AChR) antibody (Ab) Bone marrow microscopy, CK, Aldolase, Mi-2 (nuclear helicase protein) Antibody
Neurologic	Amyotrophic Lateral Sclerosis (ALS), Bulbar palsy, Central hypoglossal nerve paralysis,  Central vagal nucleus lesion, Cerebrovascular accident, Guillain-Barre syndrome, Huntington's chorea,  Multiple Sclerosis, Myoneurogastrointestinal encephalopathy syndrome, Neuroferritinopathy, Peripheral neuropathy, Polyradiculitis, Diabetic neuropathy, Poliomyelitis	anti-ganglioside antibodies, anti GM1 antibodies and Anti-GQ1b,Stool culture for campylobacter jejuni,trinucleotide repeat sequence "CAG", EMG, ANA profile,
Nutritional / Metabolic	Gaucher's disease, Plummer-Vinson Syndrome	Genetic testing, Vit B12, RBC folate, Bone marrow microscopy
Oncologic	Paraneoplastic syndrome	Hormone levels of Ca, vit D, Histamine, IL-1
Rheum / Immune / Allergy	Allergic swelling, Amyloidosis, Behcet's Syndrome, CREST syndrome , Crohn's disease, Dermatomyositis, Eosinophilic esophagitis,  Esophageal sarcoidosis, Graft versus host reaction, Inclusion body myositis, Myasthenia Gravis, Parkinson's Disease, Riedel thyroiditis,  Rheumatoid Arthritis, Scleroderma, Systemic Lupus Erythematosus, Systemic sclerosis, Xerostomia	ANA profile, RF factor, Bone marrow biopsy, Ca level, Vit D level, RNA polymerase types II and III ,RNP, Scl-70 , SS-A , SS-B
Sexual	Oral sex	Oral swab culture
Miscellaneous	Alcoholism, Aspiration of foreign body	blood culture, blood alcohol levels