Hi, welcome. So, who flagged the 5 items? They were flagged on the report? Here is one of my pet peeves . . . doctors give these reports to people but then don't sit down to explain what the results mean. You have legit questions and the doctor reading the report or who ordered the blood work is responsible for giving you the interpretation of what the issue is and if there is any follow up needed based on that. However, why did he have blood work done? Was he having symptoms of something? The nature of the CBC is that often those numbers will change. Our white blood cells are going to constantly be fluctuating. What if we have been OR are fighting something off? The numbers would look different and obviously, kids are in that position a lot since most are around other kids a lot, touching germy things, etc. Is he sick or has there been an issue?
Why is your doctor saying he is not anemic? Just looking at it, I know that a low MCV and a low MCH means there is an issue with the number (most likely) of red blood cells. Now the MCH level is really borderline for even being low. It's pretty much .5 away. But the other often means anemia. There are other things to look at though. His kidney function, liver function, if there is a bleeding issue or nutrition issue. So, I'd think if they do rule out anemia (through testing, not this quick answer from the doctor), then I'd want further follow up on this aspect to the report.
The high gra and percent gra is white blood cell count. This number being low seems problematic. Aplastic anemia? Another issue with blood? Autoimmune disorder? Any symptoms that your grandson is having? It 'can' be a problem due to nutrition as well.
Really, all in all, this report is consistent though with someone anemic.
I'd follow back up with the doctor to rule that out with further testing so you can see that for sure. And then ask what next step is to find out the cause. Let me know what happens!!