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7 year old with night sweats, difficulty in sleeping, lack of appetite. CBC showing high levels of WBC and Hematocrit. What could be wrong?

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My 7 year old has been having trouble sleeping off and on for a long time. Has night sweats at times. He always has dark circles around his eyes. He seems to feel ok other than a general lack of appetite a lot of times. Seems to have plenty of energy to play, etc. But he just generally wasn't looking "well" to me so he had a CBC. His results are: WBC- high (11.9), Hemoglobin-high (14.2), Hematocrit-high (41.0), Neutrophils (Absolute)-high at 6.1, and Monocytes (Absolute)-high at 0.9. Any ideas what could be going on if anything?
Posted Sun, 22 Apr 2012 in Child Health
Answered by Dr. Taher Kagalwala 1 hour later

Thank you for the question.

I understand you are a nurse. On evidence, it may seem that he has abnormal counts etc., but if you analyse them, they aren't far off the mean of these values for children. The only unusual thing in the blood reports is the hematocrit, which is a little lower than what I would have seen with a hemoglobin of 14.2 g/dl. I wouldn't really call a Hb of 14 as "high".

Coming to his sleep problems, I have a feeling that he is going through some phase of seeing bad dreams or nightmares during the "active" sleep stage. Check out though for other possibilities like a sinus or tonsil or adenoid problem, which can cause snoring, disturbed night sleep, drowsiness in the daytime and so on. However, you do mention that his energy level is high in the day. Hence, this may not really pan out to be a tonsil etc. related problem.

If the phase does not reduce within weeks, you might want to consult his school counsellor to rule out academic/peer related/other stressful situations causing anxiety and interfering with his sleep.

As of now, I don't think any medications are warranted.

Hope my answer would be of some help to you. Please do write back if you have any more concerns.

With best wishes,

Dr. Taher Kagalwala
Above answer was peer-reviewed by
Follow-up: 7 year old with night sweats, difficulty in sleeping, lack of appetite. CBC showing high levels of WBC and Hematocrit. What could be wrong? 23 minutes later
Hi, I was just reading the "flags" on the lab test result sheet. Out next to each of the abnormal values it says "high". I am a nurse but I don't a lot about pediatrics. My son has had this chronic insomnia for about a year now. I assume the reason his always has the dark circles around his eyes is because he isn't sleeping. I have spoken with his teacher and she says he is a model student. His grades are all 98-100 in every subject and she says he gets along extremely well with everyone and has no social problems. He says the same thing. He seems to be emotionally stable and well adjusted. He has a lot of friends and is always happy. There are no "academic/peer related/other stressful situations" in his life. He just generally looks kind of "ghostly" or "ill" to me and has for several months. Some of my other family members started to comment on it. This is why i had the CBC done-I thought well maybe he is anemic or something but that does not seem to be the case either. Nothing in the blood test results shows what could possibly be going on? He was not sick (no cold, fever, sore throat, etc) when the labs were done.
Answered by Dr. Taher Kagalwala 16 hours later

I thank you for your input and the follow-up question.

Insomnia, if it does not have anything to do with his medical problem, has to be from some inner turmoil. I firmly suggest some sessions with his school counsellor, although he looks all right to you. I am very sure there is no hematological problem causing his insomnia.

I hope I have provided you with useful information to work on with. Please accept this answer if you do not have any other queries. Feel free to address me your concerns if you have any.

With regards,
Taher Kagalwala,
Above answer was peer-reviewed by
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