hello. Welcome to HCM.
For a 19 month old child, segmented WBC are lesser when compared to lymphocytes. Upto 60% of lymphocytes are normal. In addition, platelet count
should be normal. High MCV signifies macrocytosis
and low MCHC needs to be evaluated in light of other RBC indices.
Make sure to tell us your peripheral smear findings as well.
If this has been a single episode, you can observe it simply by avoiding any kind of nose-picking
or minor trauma.
However, if the bleeding has been profuse, she need to have complete coagulation profile, as these can be early symptoms of coagulation defects. It would be best, if you can visit a good hematologist
, who will physically examine, evaluate the child and guide you further.
As a first aid, you can apply cold compress when she bleeds.
Most Importantly your child's weight is less for age, make sure to adequately feed her with solid foods. It can be a cause of macrocytic anemia