
What Causes Frequent Petechiae Despite Having Normal CBC Test?

We have seen 2 different hematologist. He has had all the bleeding disorder tests as well as several CBCs. All have been perfect.
Sometimes I will see him scratch (he scratches and the dots appear). And he gets them instantly after only 1 scratch.
Right now he has a few dots on his stomach, a few on his side, several on his shoulder and back. Almost always has a few in his diaper area. He has had 2 CBCs this week. Platelets were 303 and 301.
Also, they turn brown and fade within 1-3 days. They heal very quickly.
I'm at a loss of what to do. The hematologist say this is just him but I worry he has leukemia every time I see a new dot.
Any insight?
Not leukemia.
Detailed Answer:
Hi
Since your 2 year old son is not having symptoms of fever, extreme fatigue, shortness of breath and coughing and his complete blood count test and platelet test is normal i do not think his petechiae is due to leukemia.
Sometimes prolonged use of baby diaper can cause such petechiae to appear and it is a benign condition.
I would advise you to do a blood smear test where a small sample of blood is spread on a glass slide and looked at under a microscope to look for leukemic cells.
If abnormal numbers of blood cells and changes in the way these cells look are found in this test then he may need to do further tests such as a bone marrow aspiration and biopsy test to rule out leukemia.
Since his complete blood count test and platelet count are already normal i think there is nothing to worry and a normal blood smear test will rule out leukemia.
Regards
DR DE


If it were leukemia, would the petchaie come and go or would it spread? My sons come and go, then new appear.
Also, he does cough hard frequently. We though it was due to allergies.
Nothing to worry
Detailed Answer:
Hi
If it was leukemia then the petechiae would spread and would persist for sometime.
Since your childs petechiae come and go and new ones appear and his blood smear test is also normal with no atypical cells i do not think he has leukemia.
His cough is due to allergy and i would advise you to give him an antihistamine syrup with doctors advise.
If you have no more clarifications then please rate the answer and close the thread.
Regards
DR DE


If it were leukemia the petchaie would not heal in a few days on its own!
Also, there would be more that about 10 dots on the body. It would be widespread?
Should I conitnue to push for answers? My doctor has done all the tests and thinks he just has sensitive blood vessels. What would you advise a patient who has had all normal work ups but continues to get the "dots". It's just him and I need not worry? Or something else?
Lastly, do I need home to have a cBC each time I see them? Or consider it normal?
Application of ice or cold compression
Detailed Answer:
Hi
In leukemia the petechiae would not heal and there would be more than 10 dots in the body and it would be more widespread.
Since his blood work is all normal there is nothing to worry and i would advise you to apply ice packs or cold compressions over the affected regions of petechiae.
I would suggest before applying an ice you should put a paper towel between his skin and the ice pack.
You do not need to do a CBC test each time you see petechiae but i would suggest you do a 3 monthly complete blood count test for your child.
There is nothing to worry.
Wishing him good health.
Regards
DR DE

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