Posts by Linda Smith69

Can someone please help me make sense of these labs... I asked about the CBC results from our first trip to the children's hospital back on page 115. We're looking at a nine-month-old baby with a lump/cyst on their neck. After seeing an ENT and a maxillofacial surgeon, we went to the hematology clinic at the local hospital today. They did a finger prick, and this is what the report says:

E 4.39 Hgb 1.21 Hct 0.354 Plt 353 L 9.3 neu 21.5 ly 68.8 mo 4.5 eo 4.3 baso 0.9

After that, they sent us over to hematology and oncology for consultations (I posted more details in the child health forum). The little guy has to stay overnight at the hospital for a two-day stint because they need to biopsy the cyst—they're still not entirely sure what it actually is.

Is there anything in these results that looks concerning to anyone 😢?

Thanks in advance!

Here’s the full CBC from December 30th (just for comparison, I noticed some values have gone up)

Full CBC

Erythrocytes 4.52 (4.00 - 5.00)
Hemoglobin 124 (109 - 138)
Hematocrit 0.360 (0.320 - 0.404)
MCV 79.6 (73.8 - 89.4)
MCH 27.4 (24.3 - 29.2)
MCHC 344 (300 - 350)
RDW 12.8 (11.9 - 16.2)
Reticulocytes 36 (20 - 94)
Reticulocytes 7.9 (4.0 - 19.0)
Platelets 324 (150 - 450)
MPV 10.2 (6.9 - 11.3)
Leukocytes 10.0 (6.0 - 16.0)

Neutrophil granulocytes 1.72 (2.50 - 7.20)
Lymphocytes 7.15 (2.00 - 6.60)
Monocytes 0.53 (0.22 - 1.51)
Eosinophil granulocytes 0.55 (0 - 0.70)
Basophil granulocytes 0.08 (0 - 0.20)

Neutrophil granulocytes 17.1 (23 - 66)
Lymphocytes 71.3 (18 - 60)
Monocytes 5.3 (5 - 13)
Eosinophil granulocytes 5.5 (0 - 6)
Basophil granulocytes 0.8 (0-2)

CBC - Smear
Segmented neutrophil granulocytes 17 (23 -66)
Lymphocytes 62 (18 - 66)
Monocytes 6 (5 - 13)
Eosinophil granulocytes 12 (0 - 6)
Reactive lymphocytes 3 (0)

ABN (total neutrophil count) 1700

Glucose 5.1 (3.9 - 7.0)
Urea 3.8 (1.0 - 7.5)
Creatinine 32 (35 - 62)
Sodium 139 (134 - 142)
Potassium 4.8 (3.0 - 7.0)
Chloride 101 (96 - 108)
Calcium, total 2.56 (2.15 - 2.80)
Bilirubin, total 4 (< 20)
Bilirubin, conjugated 2 (< 3)
AST 45 (26 - 75)
ALT 22 (11 - 46)
ALP 508 (25 - 500)
GGT 9 (1 - 39)
LD 302 (150 - 360)
Ferritin 28 (7 - 140)
CRP 0.1 (0.1 - 2.8)

vividsailor7 said:The labs suggest there might be a minor viral infection going on. Otherwise, everything looks normal. See an ENT.

Thanks a ton!

Maria Fisher46 said:I don't think those slight shifts in white blood cell counts have anything to do with the lump on the neck (which we discussed earlier might be a midline thyroglossal duct cyst). It's true that those cysts can get infected sometimes, but if that were the case, there would be actual symptoms, and you wouldn't see these specific changes in the blood work.

So, my best guess—which is what I suspected and what my colleague also confirmed—is that this result is just some trace of a viral infection that probably passed by without anyone even noticing it.

It’d be a good idea to redo these tests after a little while; I'm pretty sure they'll come back totally normal then.

Best regards. 🙂

Thanks so much! We'll definitely redo the blood work. I'm assuming to nail down a diagnosis for a thyroglossal duct cyst, we need to check thyroid function through blood tests too 🤷. The cyst doesn't seem infected—the skin looks fine and the little guy isn't showing any symptoms at all.

Maria Fisher46 said:Hey Justin Morris46,

Could you let us know what the total white blood cell count was? We need that to calculate the absolute counts for each specific type, which matters way more than just the percentages. Also, please transcribe the full CBC—meaning the actual number for every single leukocyte type, not just the ones that fall outside the reference range.

Has the little guy had any kind of viral infection lately?

The baby was born at 38 weeks (3500 g/53 cm) and had a brief bout of physiological jaundice. Other than that, he’s never been sick. He eats normally and his weight gain is looking good. Only thing is, he snores at night like an adult man. I mentioned it to the pediatrician, but she said it’s totally normal for babies 🤷.
One more thing... whenever he gets really excited and starts laughing, he starts hiccuping every single time. The pediatrician didn't see a connection there, but maybe it's worth noting 🤷.

Full CBC:

Erythrocytes 4.52 (4.00 - 5.00)
Hemoglobin 124 (109 - 138)
Hematocrit 0.360 (0.320 - 0.404)
MCV 79.6 (73.8 - 89.4)
MCH 27.4 (24.3 - 29.2)
MCHC 344 (300 - 350)
RDW 12.8 (11.9 - 16.2)
Reticulocytes 36 (20 - 94)
Reticulocytes 7.9 (4.0 - 19.0)
Platelets 324 (150 - 450)
MPV 10.2 (6.9 - 11.3)
Leukocytes 10.0 (6.0 - 16.0)

Neutrophil granulocytes 1.72 (2.50 - 7.20)
Lymphocytes 7.15 (2.00 - 6.60)
Monocytes 0.53 (0.22 - 1.51)
Eosinophil granulocytes 0.55 (0 - 0.70)
Basophil granulocytes 0.08 (0 - 0.20)

Neutrophil granulocytes 17.1 (23 - 66)
Lymphocytes 71.3 (18 - 60)
Monocytes 5.3 (5 - 13)
Eosinophil granulocytes 5.5 (0 - 6)
Basophil granulocytes 0.8 (0 - 2)

CBC - Smear
Segmented neutrophil granulocytes 17 (23 - 66)
Lymphocytes 62 (18 - 66)
Monocytes 6 (5 - 13)
Eosinophil granulocytes 12 (0 - 6)
Reactive lymphocytes 3 (0)

ABN (total neutrophil count) 1700

Glucose 5.1 (3.9 - 7.0)
Urea 3.8 (1.0 - 7.5)
Creatinine 32 (35 - 62)
Sodium 139 (134 - 142)
Potassium 4.8 (3.0 - 7.0)
Chloride 101 (96 - 108)
Calcium, total 2.56 (2.15 - 2.80)
Bilirubin, total 4 (< 20)
Bilirubin, conjugated 2 (< 3)
AST 45 (26 - 75)
ALT 22 (11 - 46)
ALP 508 (25 - 500)
GGT 9 (1 - 39)
LD 302 (150 - 360)
Ferritin 28 (7 - 140)
CRP 0.1 (0.1 - 2.8)

No swollen lymph nodes on the body. The little guy is drooling a lot because his teeth are coming in. Other than that, everything seems fine, so I'm thinking the weirdness in the bloodwork might be tied to that lump/cyst under his neck.

Thanks so much 🙂!

Can someone please take a look at my 9-month-old's blood work? I found a movable lump on the baby's neck—probably some kind of thyroglossal duct cyst, though the doctors aren't totally sure yet. We’ve been talking to ENT and maxillofacial specialists, and now we're supposed to take these results to a pediatric hematology clinic at the children's hospital. I'm really hoping they can give us a straight answer once they see everything. Here are the results from today's exam:

Quick rundown from the pediatrician: 9-month-old male, doing fine overall, no fever, skin and mucous membranes look normal, no weird rashes. There's a palpable, round, movable, and painless lump on the neck in the midline, right in line with the cricoid cartilage, about 1 cm big. No signs of meningeal Sy. Throat looks clear. Lungs sound fine. Heart rhythm is steady, tones are clear, no murmurs... basically, everything else seems okay.

Ultrasound findings: Above the thyroid, in the midline at the level of the hyoid bone, there's a cystic mass with a thick wall (3.1 mm) measuring 12 mm in diameter.
The thyroid itself is normal size, homogeneous, normoechoic, with normal lobe and isthmus size.

Blood work - deviations from reference ranges:

Neutrophil granulocytes 17.1 (23 - 66)
Lymphocytes 71.3 (18 - 60)

CBC - differential
Besides those high lymphocytes and low neutrophil granulocytes mentioned above:
Eosinophil granulocytes 12 (0 - 6)
Reactive lymphocytes 3 - should be 0

Biochemistry
creatinine 32 (35 - 62)
ALP 508 (25 - 500) ??

Thanks in advance for any help!