21 month old with reaccuring infections and abnormal blood work

[llizac0616]

my son is 21 months old and has been sick for several months now, his symptoms are high fevers, leg pains, pale skin and weak eyes. he has been hospitalized twice in the past month and his blood work is identical both times, we are currently waiting for an appointment with the hematologist but his CBC results are the following, WBC 18-30k, RDSWD 46.5-47, RDW 15.8-18, PLT 476-500, Neutrophil 20.5, LYMPHOCYTE 6.9 CRP 7.339, these are all the blood counts that are listed as high, he had a blood smear preformed which states the following " Leukocytosis with myeloid left shift. Erythroctes show mild anisoctyosis; are otherwise unremarkable with large and small plt clumps present which may artifactually lower the measured PLT count. Reactive process is favored; clinical correlation suggested." can anyone give me any insight to what this may mean. The dr at the hospital that we were being treated at felt like he just had a reoccurring viral infection, but our general pediatrician is quite concerned and is not happy in the lack of further research that we received....

[Ken_PA]

"its every 2-3 weeks he gets sick"

Hi, it's always a good idea to educate yourself as much as possible before doc visits so that you don't waste the limited time with a doc on basic questions. So I'd recommend getting at least a little familiar with the concept of Periodic Fever Syndromes. That's especially true if your son's episodes of sickness seem to come at almost regular intervals.

https://en.wikipedia.org/wiki/Periodic_fever_syndromes

Those are problems with the immune system and don't require any actual infection to be present - the child's immune system just keeps acting as if there was some infection. Some are limited to certain regions or ethnic groups, others are not. There are almost certainly other similar syndromes which aren't even known yet. The immune system can do mysterious things.

You can also spend some time going over family history looking for unusual immune conditions.

Also, don't get terrified if any scans are done and find enlarged lymph nodes - the immune system can do that without any cancer being present.

Good luck with the appointment, I hope it's not too far away.

[llizac0616]

Thank you so much for your response, to further elaborate on the duration of the illness, he has been hospitalized twice in the past two months, but he has been sick going on 7 months now its every 2-3 weeks he gets sick. He seems to stay sick more than well and it is so frustrating to see such a tiny tot go through SO much. We received our appointment today with a highly recommended hematologist in Atlanta Ga who is through the Childrens hospitals of atl. Our pediatrician says he will deffinatly run his series of blood test and give us a definite answer to what is going on! I am so ready to get this out of the way and be over this terrible illness that has taken over my baby no matter what it may be! Thanks again for the reply it did defiantly ease my mind!

[Ken_PA]

Hi, the phrase to zero in on is "Reactive process is favored". That means the immune system is likely reacting to some infection.

I think the cause for concern should be about what that infection is and why your son's immune system is not defeating the infection after two months - but don't worry at this point about leukemia.

leukocytosis = white blood cells (immune cells) are high, which usually happens in response to an infection (like troop numbers increasing during war time)

myeloid left shift = new neutrophils are being rushed into production to fight infection (like having lots of new recruits)

Erythroctes show mild anisoctyosis = perhaps that's just a false result, since the platelets are clumping and that can give false impressions that red blood cells (erythrocytes) are unusual

CRP = high inflammation, typically from infection - which may be causing the platelets to clump/aggregate. Inflammation can also cause a rise in platelet numbers. Since there is some platelet aggregation going on, the actual number of platelets is actually somewhat higher than the reported number, and some of those clumps of platelets are being seen as odd-sized red blood cells (anistocytosis).