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Dr. Andrew Rynne

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Child has large lymph node on neck. Blood test done. What does the value indicate?

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Dr. Rajiv K Khandelwal

Pediatrician

Practicing since :1976

Answered : 1872 Questions

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Posted on Mon, 4 Mar 2013 in Child Health
Question: My 6 year old son had blood work done. His alk phos came in at 305, bun creatinine ratio came in at 55. He has a large lymph node on the left side of his neck. His RBc and creatnine were low and lymphocyte was high 51.1. He has been to an ent for allergies. He has a lot of seasonal allergies. We had gone to the doctor because he has a lot of mucous and can't blow his nose. He keeps making sounds like he is sucking the mucous in. Should we be concerned about some of the numbers in his blood results. We have an appt with his pediatric soon and ent again at end of month.
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Answered by Dr. Rajiv K Khandelwal 1 hour later
Hi,

Thank you for your query.

I shall try to address your concerns which, if I understand correctly, are:
1. The blood reports.
2. Allergies and diet.

In the blood report, alkaline phosphatase though high does not have any significance if the other liver enzymes and function tests are normal. The BUN is on the higher side but you mention that creatinine is low. What about the urine routine report? If urine report is normal then one would like to follow up the BUN in the coming months. The RBC and lymphocyte report should be read along with the other blood counts and not in isolation.

Your son should not stay away from nuts and watermelon unless they increase his complaints. Under the guidance of your doctor you will come to know which things to avoid.

With appropriate treatment the allergies can be controlled and your son shall stop making the sounds which you mentioned.

I hope I have responded to your queries to your satisfaction. Please feel free to revert back in case you need any clarifications or would like to share more facts.

Wishing your son all the best.

Regards,

RKK
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rajiv K Khandelwal 1 hour later
They did not tell me about the urine he did that same day. I would assume it was normal. I was just concerned because the urgent care doctor that we went to because we could not get into the ped doctor til Friday said that a number that high on the alk phos "a high marker like that can sometimes be elevated with liver/gallbladder disorders but also problems of the bone.often elevated in children but not this high (305)" So we are concerned. The only ones that were low on the one report were the RBC, Hemoatocrit, and the lymphocyte were high, everything else was in normal range. Doctor said lymph node on his neck was 1.5 and she does not like to see it more than one? He has fair more food allergies on paper so it is hard to know what can cause the allergies.
Oh what other test for the liver function would they be on a metabolic test I have two sheet plus the the mono test which came up negative.
doctor
Answered by Dr. Rajiv K Khandelwal 11 minutes later
Hi,

Thank you for the update.

I suggest that do not take the reports in isolation but to reveiw them with the other reports in hand. Yes alkaline phosphatase is one test but has to be seen in combination with SGOT and bilirubin levels. Same holds good for the values in the hematocrit.

If the lymph node is not enlarging and is not associated with pain then it can be kept under observation.

Regarding the food items causing allergies. It is best to challenge your son with each item one at a time and observe which item caused problems. These should then be avoided.

I hope I have responded to your query to your satisfaction.

Wishing your son all the best.

Regards,

RKK
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rajiv K Khandelwal 16 minutes later
Thank you can't wait til his doctor appt to get him straight. I looked back always seems like he is sick around this time of year so maybe a seasonal allergy thing going on.
doctor
Answered by Dr. Rajiv K Khandelwal 1 hour later
Hi,

It is good that I have been able to make things a bit clearer. It is always good to discuss with the treating doctor and get all the things cleared as he is in the best position to guide you.

If your son gets problems this time of the year and you suspect seasonal allergy then it shall be a good idea to try to find the things of the season in the environment which may be affecting your son and giving him allergy.

Wishing your son all the best.

Regards,

RKK

P.S.: In case you intend closing the query then do provide a reveiw.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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