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High ESR and platelet count, lymph nodes on cervical region increased, cold, infection, taking Cetrizine. Is it something to worry about?

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Pediatrician, Infectious Diseases
Practicing since : 2005
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Hi. My 6.5 yrs son had a blodd test last week and the results came back with two high counts. ESR=68 and Plaetlet count=503. All other things are normal including Total white cell count=12.28 , Neutrophil=7.54 , Lymphocyte=3.89 , Monocyte=0.64 , Eosinophil=0.12 , Baspophil=0.09 and Haemoglobin=12.9 , RBC count=4.75 , Haematocrit=0.379 , MCV=79.8 , MCH=27.2 , MCHC=34 , Liver Serum albumin=47 , Serum total bilirubin level=4 , Serm alkaline phosphatase=185 , AST serum level=29 , and ALT/SGP serum level=10.

Are two high counts (ESR and Platelet) are something to worry about?
The resaon the doctor wanted the blood test was that one of his lymph nodes on the cervical region (right side on the neck) has become large (est 3cm) after he had a cold and infection a month and half ago. As his GP said in his report, that has been an both sides.

He is generally well with no fever or any other syptoms though he has had allergy months before and being given Cetirizine tablets for that. We also noticed today that he is growing a new teeth at the back on the right lower jaw.
Posted Sat, 9 Jun 2012 in Child Health
 
 
Answered by Dr. Hema Yadav 4 hours later
Hello,
Thanks for posting your query.
High ESR in your child's case could most probably due to allergy which can cause high ESR , high eosinophils etc . The platelet count could be a variation of normal .
Secondly ,both of this with upper respiratory symptoms and lymph nodes could be an indication of underlying viral or chronic bacterial infection( tuberculosis) .
However it seems less likely since he has no fever , weight loss, cough , etc.
Assuming the child has been examined by a doctor and considering the details provided , the situation doesn't seem worrisome and even if it's as a result of an infection(viral) or inflammation (teething ) etc it is likely to resolve within a couple of weeks . If the child has persistent of lymph nodes , high ESR ( repeat testing ) beyond 4 weeks then it's necessary to rule out significant disorders like malignancy , tuberculosis etc . This can be done by tests like fine needle aspiration cytology of the lymph nodes , tuberculin test , blood smear examination etc.
As of now nothing needs to be done but a watch for the development of any symptoms is advisable .
Meanwhile if the child is having a allergic tendency or recurrent respiratory infections it's advisable to consult an allergist or ENT surgeon or an experienced pediatrician for the best management of such conditions.
Hope I have answered your query.
Wishing you and your child good health.
Regards
Above answer was peer-reviewed by
 
Follow-up: High ESR and platelet count, lymph nodes on cervical region increased, cold, infection, taking Cetrizine. Is it something to worry about? 49 minutes later
Thank you so much for answering my question. Just kindly explain one thing I didn't understand please.

In your sentence:

"If the child has persistent of lymph nodes , high ESR ( repeat testing ) beyond 4 weeks then it's necessary to rule out significant disorders like malignancy , tuberculosis etc",

do you mean if it's there more than 4 weeks, we should consider the possibility of it being a significant disorder like malignancy , tuberculosis etc? or does it mean it couldn't be a significant disorder like malignancy , tuberculosis etc?

Please advise. I am too worried.

Many thanks.
 
 
Answered by Dr. Hema Yadav 5 hours later
Hello,
Thanks for the follow up.
Please do not worry as I do not mean to say that all lymph nodes persisting beyond a month are suggestive of tuberculosis or malignancy.
Many times especially in children there can be lymph nodes seen for many months due to either, allergy , skin disorders or repeated infections.
But if high ESR , low grade fever, generalized or multiple lymph nodes , failure to gain weight , decreased appetite etc are noted for more than 3-4 wks then it is best not to neglect it as there are chances of an underlying problem like tuberculosis and malignancy.
In your child it seems unlikely , as he has no other symptoms and all his reports except ESR are within normal range so please relax! However I just provided you this information so that even in future you can keep a watch and even the slightest risk can be appropriately ruled out to be on the safer side.
Please do not stress out and in case you do feel anxious then go for regular follow up check ups of your child by your doctor to monitor his recovery and growth .
Hope this answers your query.
Wishing your child good health forever .
Regards
Above answer was peer-reviewed by
 
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