9 year old son-please help

[zasmom]

Hi. My family and I have been going through a nightmare of testing. Our son has been limping for quite a few years-it seems to be exercise related. He seems to become fatigued and his left leg begins to weaken, causing him to limp. We took him to a orthopaedic specialist at our local children's hospital. The doctor ran a CBC with differential and suspects he may have a mild form of muscular dystrophy so performed a MDM as well (the results are not yet in). The CBC showed high Eosinophils, high Basophils, and low lymphocytes. We were told that it is likely allergy related and to follow up with the family doctor. We followed up with the doctor and a stool sample and abdominal x-ray were done. The stool sample was negative for parasites and the abdominal x-ray showed moderate stool-unremarkable were the remarks. 3 weeks after the initial CBC, the family doctor performed a repeat CBC and liver enzymes. The Eosiniophils were now even higher at 28%! Needless to say we are frustrated. His AST was mildly elevated at 47 (43 at the initial test). I've read that the AST is not always related to the liver but relates to the heart as well. His doctor mentions that he also has pre-hypertension but I don't get it because his blood pressure is generally always 95/64 or so but because he is being tested for Muscular Dystrophy and I know that heart conditions can be associated with Muscular Dystrophy, I am terrified that his AST is elevated and that his doctor says he has pre-hypertension. The Eosinophils are of particular concern. Can someone please please please help me with this? We are going to an immunologist tomorrow at our children's hospital but I want to be sure I'm not taking the wrong road. I am fearful something is wrong with his heart. Thanks

[zasmom]

Okay thank you for the input. We were recently referred to the department of Hematology at our local Children's Hospital. Hopefully we will have an answer soon.

[PaulMD]

Increased eosinophils is more of a marker of certain conditions (such as allergies or parasitic conditions) and should not directly cause organ damage.  The biopsy is an option but the decision would really depend on what your doctors think (since they are the ones who actually see the patient) and with your discussion with them.

Regards.

[zasmom]

Thank you so much! I will discuss the biopsy with his doctors. In your opinion, are the Eosinophils of particular concern (2.5 absolute range=0.1-0.5) or can I rest easy about this not causing organ damage?

[PaulMD]

I will not be bothered much by the AST.  The two points above the normal cut off level may not really be significant.  Besides, AST is too non-specific to think that its coming from the heart.  To settle things about muscular dystrophy, you may discuss with his doctors regarding a formal muscle biopsy.

The high eosinophils may indeed come either from allergies or from parasites.  Sometimes, parasites can embed in muscles even if the stool does not show these parasites.  All the more reason to have a muscle biopsy entertained.

I suggest you have these options discussed with his doctors.  Regards and God bless.