My 2.5 Year Old Daughter, Weight 12.5 Kg , Height

Posted on Mon, 18 Nov 2019

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Mon, 18 Nov 2019 Answered on

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Question : My 2.5 year old daughter, weight 12.5 kg , height about 3 feet was diagnosed with ITP at XXXXXXX new XXXXXXX on 24 October 2019 with blood platelets counts of 25000, wbc 7.92, Neut 2.94 , Eos 0.16 , RBC 4.58 , HGB 10.8.
DLC percentage - N 38, L 55, M 5 , E 2
She had fever with cold and cough on 26, 27 and 28 October which is gone after litle PCM.
She also had itchy small rashes near armpits and near ears , which are gone now.
Now she had again little cough n cold with mild fever on 13, 14 , 15 November . But now the fever is gone after PCM was given with little cough as on date.
Again CBC was done on 15 November at XXXXXXX with results as WBC 25.04, blood platelets counts 150000, RBC 4.64, HGB 10.7
DLC percentage - N 71 , L 18, M 9 , E 2. Absolute N 17.89, L 4.63, M 2.3, EO 0.13 , BASO 0.09 , IG 0.22
She is eating well with little choosy and has no rashes on skin n nil inflammation.
She is playful mood and gets good sleep.

Answered by Dr. Shailja Puri (49 minutes later)

Brief Answer:
The raised WBC and neutrophil count is expected to come down

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The white blood cell count is raised with neutrophilia.
Increase in neutrophils and white blood cells is seen in case of infection.
The raised white blood cell count could be due to fever and cold which is mentioned in your clinical history.
You may get complete blood counts repeated after few days.
The raised white blood cell count and neutrophil count are expected to come down to normal after few days.
In addition, the peripheral blood examination in your report shows microcytic hypochromic red blood cells and hypersegmented neutrophils.
This blood picture is seen in iron deficiency anemia and hypersegmented neutrophils are seen in deficiency of vitamin B12 and folic acid.
I suggest you to get iron studies, vitamin B12 and folic acid levels.

Thanks and take care
Dr Shailja Puri
KINDLY HIT THANKS

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shailja Puri (1 hour later)

Thnx ma'am.
I have uploaded few more reports related to iron and folic .
Plz have a look .

Answered by Dr. Shailja Puri (3 hours later)

Brief Answer:
Iron suuplementation should be taken under supervision of a pediatrician

Detailed Answer:
Hello and welcome again,
The reports posted by you show a normal folate level.
Iron profile shows low transferrin saturation and high transferrin.
This picture suggests iron deficiency sate although the levels of iron and ferritin are within normal range.
Ferritin should ideally be between 40-60 ng/mL.
Thus, I suggest you give iron supplementation to your child under supervision of a pediatrician.
Vitamin B12 levels should also done.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Shailja Puri (6 hours later)

Good morning n thnx ma'am.
My daughter is bit choosy in food .
She eats fruits n food as per her choice .
She also drinks less water n nil milk during day. She is being feed goat milk by nipple during night when she sleeps.
Moreover I am a bit worried about some serious disease after reading through some articles n blogs about causes of increased WBC .
Kindly suggest some diet plan for her .
She also takes a lot of stress when given medicine. She feared n cried a lot during latest CBC test on 15 November.

Answered by Dr. Shailja Puri (8 hours later)

Brief Answer:
Vitamin B12 levels may be done

Detailed Answer:
Hello and welcome again,
There is nothing to worry much about raised white blood count.
The prominent feature on peripheral blood smear is hypersegmented neutrophils.
These type of neutrophils and seen in deficiency of vitamin B 12 so I suggested you to get vitamin B12 levels in blood.
In case, there is vitamin B 12 deficiency supplementation may be required.
Although goats milk has reasonable amount of vitamin B12, still vitamin B12 level may be done due to presence of hypersegmented neutrophils.
At 2.5 years of age, you can give all cereals and fruits to your child.
Its natural for a child to cry and feel the pain during blood collection.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Shailja Puri (3 hours later)

Thnx ma'am.
She was bathed by hot water today and after that she got little fever today 2pm and after giving PCM she is ok now.
She has few coughs and little sneezing.
She is eating well as usual.

Answered by Dr. Shailja Puri (1 hour later)

Brief Answer:
Fever, elevated WBCs and neutrophils may be due to URTI.

Detailed Answer:
Hello and welcome again,
fever accompanied by cough and sneezing can be due to upper respiratory tract infection (URTI).
And this can be the cause of elevated white blood cell (WBC) count and elevated neutrophils.
Upper respiratory tract infections are common in children.
There is nothing to worry as long as child eats well and achieves developmental milestones as per age.

Thanks and take care
Dr Shailja Puri

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Above answer was peer-reviewed by : Dr. Prasad