Hello, I am writing about my 7 yr. old daughter, Lauryn. I may be over-reacting but she has been sickly since the day she was born. She was a premie and almost died at one-week-old with spinal menengitis(sp). She's also had surgery at Children's hospital for a stage 4 bi-lateral kidney reflux. Anyway, recently we noticed that she had a large lymph node on one side of her neck. She took antibiotics for 10 days. The node didn't change in size at all and now has 2 more lumps on that side of her neck. They are not up by her ear. We took her back to the Dr. and he did blood work. After the blood work he just sat there staring at the paper and looking at us and then staring at the paper again. Finally he said he would give her another round of antibiotics and if that didn't do it then they would biopsy the lump. Her blood showed no infection but he said it puzzled him. I have the values if anyone knows what to look for. I am concerned because she still shows to be anemic but her iron level was fine. Her platlets are now almost double what they were just 2 months ago. Does anyone have any advice for a scared mom? Thanks for listening. God Bless.

I saw your message last night, but was waiting to defer to someone with more expertise. However, I will say that I find the platelet count going up as a red flag. It can indicate a problem other than infection. (My own daughter has an elevated platelet count, that we are waiting to see a rheumatologist for).And the lumps multiplying? I wanted to ask if your doctor was a general pediatrician or a specialist. If a general MD, he may be groping for a logical answer, hoping it isn't more than an infection. If a specialist, then I bow to him. http://www.healthboards.com/ubb/smile.gif

Thanks for the information. Her doctor is a family practitioner. He did tell us to run all this by her pediatric urologist at Children's Hospital. She already had an appt. with him scheduled for this coming Monday, so we will ask him then. You are right, I think, in that her doctor is hoping this is only an infection and not something else. He is very special to my daughter and follows her medical needs pretty closely, being that she has always been sick with one thing or another. Have they given you any indication as to what could possibly be causing your daughter's elevated platelet count? I will let you know if we find out anything more. Thanks again for the reply. God Bless!

My daughter is 25, and has a constellation of minor symptoms that could be an immune disorder. If your daughter has been so sick, it would stand to reason that her own immune system might be compromised. If she's been on lots of antibiotics, then good nutrition is especially important...if she's picky or has lost her appetite, smoothies w/ extra protein and vitamins might go down. My daughter is an adult, and she's still picky! Good luck. I can imagine the anxiety you are going through, although it sounds like you are in good hands.

The two events [lumps and elevated platelets] may not be directly related.

Blood counts - two important aspects are examined: the overall 'look' or pattern of the various blood components as well as actual levels. The standard CBC Diff typically done by computer just gives you a quick overview of types and percentages of white blood cells. There's another, more involved version of this test that must be performed by a skilled technician who actually looks at a slide and counts the various white blood cells looking at characteristics as shape and stages of maturation.

Anemia can be caused by factors other than low iron levels.

The best thing you can do for the moment is gather as accurate as possible a chronology of her symptoms and bring this info with you when you see the specialist. This includes a history of all her meds. Make this a complete, unedited chronology; don't guess what may or may not be important. You don't have the expertise, let the specialist decide what is trivial or irrelevant.

For lymphoma and leukemia, tests include CBC Diff and a spinal tap.

The Merck manual has ranges for virtually every test imaginable and has these for children by age/weight.

The most reliable sites for cancer information are:

National Cancer Institute http://www.nci.nih.gov/

ACOR [association of cancer online resources]

Oncolink [at U. Penn.]

Also try the Leukemia & Lymphoma Society and Candlelighters.

Good luck,
Jay

Just remembered - our HEM/ONCs also requested our child's immunization schedule. [Turned out not to have been relevant in our case, but it was important to rule it out.]