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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do These Altered WBC And Platelet Counts Indicate?

My four year old had some labs drawn recently because we are trying to figure out why she keeps getting these high fevers. She has a history of neutropenia in the past but we were followed by a hematologist for a while last year and her counts were always ok so we were discharged. Her labs yesterday were as follows: WBC 4.2 Thousand/uL RBC 4.81 Million/uL      Hemoglobin     13.2 g/dL      Hematocrit     38.9 %      MCV     80.9 fL      MCH     27.5 pg      MCHC     34.0 g/dL      RDW     12.2 %      Platelets     227 Thousand/uL MPV     8.6 fL      Neutrophils Absolute     1,008 cells/uL      Lymphocytes Absolute     2,772 cells/uL Monocytes Absolute     252 cells/uL      Eosinophils Absolute     126 cells/uL      Basophils Absolute      42 cells/uL      Neutrophils 24% The smear has been manually reviewed and the manual differential has been reported. Lymphs     61 %      Atypical Lymphocytes Relative 5 %      Monocytes 6 %      Eos      3 % Basos. 1 % Differential Comment: Evaluate results with caution. The white blood cell count and platelet count may be altered due to interferences caused by the presence of significant numbers of large/giant platelets. Tear-drop cells 2 + Ovalocytes 1 + I’m a bit concerned about the differential comment, is this anything to worry about?
Thu, 7 Jun 2018
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Pediatrician 's  Response
Hello and Welcome to "Ask A Doctor" service. I have reviewed your query and here is my advice.
The one number that is not normal is in the differential comment. It c 1,008cells/uL. This is low for a 4year old. A low neutrophil count is known as neutropenia.
Neutropenia plus periodic fevers is called cyclic neutropenia. This condition has episodes(about every three weeks with each episode lasting about one week) of fever, enlarged lymph nodes(or "glands"), skin
infections, muscle pains, or pneumonia.
The diagnosis is made by repeating the blood test that you placed in the User's Question three times a week for two months unless the neutropenia
is confirmed sooner.
Hope I have answered your query. Let me know if I can assist you further.
Arnold Zedd, MD, FAAP
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What Do These Altered WBC And Platelet Counts Indicate?

Hello and Welcome to Ask A Doctor service. I have reviewed your query and here is my advice. The one number that is not normal is in the differential comment. It c 1,008cells/uL. This is low for a 4year old. A low neutrophil count is known as neutropenia. Neutropenia plus periodic fevers is called cyclic neutropenia. This condition has episodes(about every three weeks with each episode lasting about one week) of fever, enlarged lymph nodes(or glands ), skin infections, muscle pains, or pneumonia. The diagnosis is made by repeating the blood test that you placed in the User s Question three times a week for two months unless the neutropenia is confirmed sooner. Hope I have answered your query. Let me know if I can assist you further. Arnold Zedd, MD, FAAP