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Child Gets Intermittently Sick, Diagnosed Every Time To Be Viral. Labs Shows Normal Alp Level. Cause Of Recurrence?

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Posted on Mon, 10 Jun 2013
Question: My son has been sick off and on since he was 11 months old. It always presents with the same sx's fever, cough, sores in mouth and now high alp level 1,763. He maybe has a week in a half out of a month where is is well. Im frustrated because doctors tell me its viral everytime. We have previously had my son's bloodwork done before he got sick and he had a normal alp level of 200. If it is just a virus then why is his alp level increasing?
doctor
Answered by Dr. Imraan Hussain (24 minutes later)
Hi XXXXXX

Thanks for your query

I can feel your concerns

It’s not just only just the virus which is culprit, but there are certain other causes which can raise this ALP level.

The most common one is growing bones at this age group
Obstructions of some channels in the liver

I would like to know that
1. Is the child weight is appropriate for age?
2. Is there jaundice?
3. Is there any change in stool or urine color?
4. What are his bilirubin and ALT levels?
5. Is there any family history of allergic disorders?

This much high level of ALP should need further workup.

I will be waiting for your follow up queries

Wishing him a speedy recovery
Regards
Dr XXXXXXX Hussain

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Imraan Hussain (13 hours later)
My son is on the 75% range for wt. This is a decrease over the last 6months, he use to be on the 100% range. His physician is not concerned because he is still considered at a healthy wt for his age (21 months and 30 lbs). My concern is he is not gaining though as I beleive he should. 10-12 ozs in 6 months is not much to me. He is not jaundice but has developed dark circles under his eyes. His bili is normal (0.40) ALT is normal (34). He has had a shift in his hemoglobin level in a weeks time it went from 12.0 to 10.6. Why such a shift Im wondering? No stool changes or urine color changes but his urine smells very oderous? We have a strong family hx of leukemia on the materal side. My other son who is 17 now had childhood wheat and egg white allergies. Asthma exacerbations until a few yrs ago, now he is fine. Everything that was elevated on his labs are: AGAP 19, Bun/Creat Ratio 25, WBC 19.89 and protein 8. Low levels include: MCV 76.3, MCHC 26.3, Seg percent man 34, sodium 135 and of course the elevated ALP at 1,763. What additional labs and tests can we do to ease my mind? Something just isn't right. I've never seen a child be so sick and run a 104 temp and no explanation for it?
doctor
Answered by Dr. Imraan Hussain (21 minutes later)
Hi XXXXXXX

Thanks for your follow up.
So sorry to listen all that.

WBC count is very high and its showing infectious process going on he may need antibiotics after blood and urine culture and sensitivity report, that’s why he is running such a high fever.

Do get his blood peripheral film done to rule out leukemia or allergic disorders.

Also, do his X-ray left wrist PA view for the workup for rickets
Low Hemoglobin can be improved with diet containing iron and iron supplements.

Kindly do consult your doctor again for the management of infectious process
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health".
regards
Dr XXXXXXX


Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Imraan Hussain (44 minutes later)
Everytime he gets sick thats what they do is give him abx's and fluids. He stays healthy for a few weeks then he is sick again. I will requests the above mentioned tests from his physician. Thank you so much :)
doctor
Answered by Dr. Imraan Hussain (6 minutes later)
Thanks for your comments.

I wish him good healthy life.

regards
Dr XXXXXXX
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Imraan Hussain

Pediatrician

Practicing since :2007

Answered : 821 Questions

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Child Gets Intermittently Sick, Diagnosed Every Time To Be Viral. Labs Shows Normal Alp Level. Cause Of Recurrence?

Hi XXXXXX

Thanks for your query

I can feel your concerns

It’s not just only just the virus which is culprit, but there are certain other causes which can raise this ALP level.

The most common one is growing bones at this age group
Obstructions of some channels in the liver

I would like to know that
1. Is the child weight is appropriate for age?
2. Is there jaundice?
3. Is there any change in stool or urine color?
4. What are his bilirubin and ALT levels?
5. Is there any family history of allergic disorders?

This much high level of ALP should need further workup.

I will be waiting for your follow up queries

Wishing him a speedy recovery
Regards
Dr XXXXXXX Hussain