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Does my child’s FBC require further investigations?

My son aged 3 has been having problems since July.

Main symptoms at the moment are decreased appetite that’s lead to weight loss. His bmi is now 1.6 percentile, before June it was 35%. Disturbed sleep, waking several times a night. 4 out of 5 nights he’s drenched in sweat. In november my son had a few episodes of pale stools and now his stools have been abnormal ever since! They’re yellow in colour, sometimes frothy and loose, sometimes like water that doesn’t stop for a while, other times constipated so he can’t go even if feels he needs to.

We’ve been to the doctor a few times about it and the last time in November before the stool changes they sent my son for a blood test. The abnormal results were :

B12 - 1145 ng/l (normal 211 - 911)
Platelet - 401 10*9/L (normal 150 - 400 10*9/L)
Neutrophils - 7.99 10*9/L (normal 2.00 - 6.00 10*9/L)
Basophils - 0.19 10*9/L (normal <10 10*9/L)

Now the doctor felt these didn’t require further investigation despite been abnormal, he suggested some other tests if I was worried. I decided to wait until after Christmas and see how things went, maybe he’d eat better/sleep better etc and then my son wouldn’t be put through needless tests.

Now things haven’t changed and I weighed my son for the first time since November and was horrified by his weightloss as he seemed to be eating better to me so I booked to see the doctor (gp) who agreed that more tests needed to be done to figure out the cause of the problems. He referred us to the hospital and this week that has been declined by a consultant with no information as to why. I am wondering how I should push to change this? Are the old blood results enough to say more investigations are needed? Surely multiple abnormal results require some form of follow up blood test?

We can not keep going like this as it is affecting every aspect of his life and he is only little. He should be happy, sleep well, eat well, be healthy etc.
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363281 tn?1643235611
Hello~I would most certainly force the issue, you know your son, you know how he feels, and from what you have described, I would definitely say he needs more tests and and to be taken seriously. I would again mention the abnormal test results, and especially how your son is loosing weight and not doing well at all and seems to be getting worse right in front of you, if that doesn't help, take it to the hospital board.

I would say if they haven't already, they should check his liver functions, blood sugars, stool samples, metabolic profile,  Candida, etc.

I am also thinking if you don't get results, then see a reliable Naturopath, that was my main doctor when I lived back home in the states. They will certainly run all kinds of tests that regular doctors don't even know about, will take a thorough case history and work with you. They will also test for food allergies, and all kinds of vitamin deficiencies.

I hope you get the help you are needing, it is ridiculous that the doctors are treating you like this, your sons situation, in my opinion, definitely needs more attention.
Helpful - 0
Thank you sassy for your very detailed response. I will try and answer all the questions.

First I’ll say my son has other issues. He was diagnosed with ketotic hypoglycaemia when he was 9 months old. They did lots of blood tests to rule out other things like glucagon storage diseases but I was recently told by the paediatrician the only 100% way of ruling that out is with genetic Testing that they aren’t prepared to do.  My sons sugars are stable on the few occasions we’ve checked during the night sweats. We don’t test his sugars often but I might start doing it on a morning and keeping a log for a week.  

He’s also got milk intolerance which we’ve been told to reintroduce but I’m waiting until bowel changes return to normal so I can spot any intolerance signs.  We saw a dietitian about reintroducing milk in September and she noted the weight loss during that appointment but she’s not got in touch with us since.

He was also born with a birth defect called hypospadias, the first surgery to correct this failed due to flap necrosis which the surgeon said was very rare and due to lack of oxygen to the flap, it caused a wound infection and surgical breakdown. They didn’t know why this happened. The re-do surgery was a success.

My son has suffered constipation since birth until the bowel changes a few months ago. We usually give him movicol to relieve this but that is not needed anymore.

The only tests they’ve done is the blood test and that looked at liver function which was normal.

I am still in shock that they’ve declined the referral to be honest, it seems madness to not to do a repeat blood test at the very least. Possibly the reason for refusal is because the GP requested a new paediatrician who could look at my son with fresh eyes, perhaps the paediatrician felt snubbed or maybe we have no right to this and need to stick with the same doctor? This is the same paediatrician we see for ketotic hypoglycaemia and have 6 monthly check ups. I wish we could afford to go privately but December/January has been a difficult month as my partner is self employed. Thank you for taking the time to respond, I really appreciate it.
I think it would be wise to check your son's blood sugars after each meal and fasting each morning, I would do this for a couple of weeks. Doing this may catch any high sugar spikes. Also, ask the doctor to order an A1c blood test, this shows what the blood sugar has been doing for the last 3 months.

I think seeing a different pediatrician would be a good idea, you say you would like to go "private" that sounds like over here in New Zealand, we have to pay high fees unless we go "public" We also aren't allowed more than one GP, if we do, fees go up again. I would insist on a different pediatrician and more tests, it would appear to me that none of the physicians want to take the time to research what is wrong.
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