Lab review

[CarolinAlaska]

Yesterday Jaedyn had her 4 week bloodwork after starting 6MP.

WBC 4.5 (5.0-11.0) low
RBC 3.98 (4.10-5.10) low
Hemoglobin 12.9 (13.0-16.0) low
Hematocrit 37.9 (39.0-48.0) low
Cell sizes are normal.

Neut% 53.4 (25-70)
Lymph% 26.8 (20-40)
Mono % 12.3 (0-10) High
Eos % 7.1 (0-4) High
Baso % 0.4 (0-1)

Na 143
K 4.8
Cl 104
TCO2 32.0 (18-27) High
Other anormalities include:
AST 44 (5-41) High
ALT 50 (6-40) High

The EOS make me wonder if she's getting an allergy to the med, but the absolute count is normal. The TCO2 indicates metabolic alkalosis - any thoughts on this? It is a significant change from 2 weeks ago. Formulas didn't change in that time... She's never had anemia before now. Could it be a med side effect? WBC count was 4.9 two weeks ago...

 

[Catherine]

The aim of aza is to lower the white cell count to I believe around 4.0.

The hemoglobin level is only borderline for anemia. What was it 2 weeks ago?

 

[CarolinAlaska]

Hgb was 13.1
Eos % 6.4
AST 41, ALT 45

So, I see it isn't much different. TCO2, however was 29.0. The pediatrician says she wants to talk to the peds GI about what she thinks it means... I'm not too worried about it, as Jaedyn seems healthier than she has in her life

 

[Dexky]

I know it's concerning that they're moving in the wrong direction but I'd love EJ's labs to look like that!

 

[AZMOM]

I agree with Dex.

Watchful waiting is hard but I think you but the mail on the head when you said she feels good. Labwork is part of the deal, to be sure, but how they feel is equally part of the picture! Glad she's feeling well .
J.

 

[Catherine]

Carolin

The drop in hemoglobin is normal varience between tests. But as she is on the low end of normal range check you have base levels for iron, folate and B12.

If you have them and they more than 6 months old you may want to try and have one added to each of the standard aza blood tests.

 

[xmdmom]

The range of normal hemoglobin (13-16) is higher than usually given. A hemoglobin of 12 is usually considered the lower range of normal, so 12.9 is fine. The increased eos is the main thing that stands out and does suggest the possibilities of an allergy.