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Child is feeling week and tired. Test done for wbc, monocytes level. Are the findings normal?

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My son has been tired and not himself for a week and has no fever. WBC is 12.4 and monocytes 6.4, everything else normal. Should I be alarmed?
He is 2 and a half.
Oh, and neutrophils are 38.3. Reference of 15-35
I realize these are slight elevations, but can anything major like malignancies/leukemia be present with a white cell count that is slightly elevated? The lab paper says the reference range is 4.0-12.0, so 12.4 is slight but I'm a NICU nurse and worry too much.
This combined with him not being himself and being tired. When I ask him if he hurts he says his head.

These were drawn yesterday.
Posted Mon, 13 May 2013 in Child Health
Answered by Dr. Y V Siva Sankara Murty 3 hours later

Thanks for writing to health care magic.

Do not worry.

The normal values of these investigations vary with age. Normally most of the laboratories give the adult range for these investigations.

The normal total leucocyte count for a 1 to 3 year old is 6 to 17.5.

Was a peripheral smear examination done?

Hope this helps. Please ask further queries as required.
Take care.
Above answer was peer-reviewed by
Follow-up: Child is feeling week and tired. Test done for wbc, monocytes level. Are the findings normal? 59 minutes later
Peripheral smear? I don't know what that is.. So prob not.
He played well tonight but is toned down. It's been 6 days since he's been normal so hopefully he is 100% soon.
If I ask him if he hurts anywhere sometimes he says no and sometimes he says "yeah, my head". He also has been rubbing his eye and squinting at the tv; not all the time but sometimes. His vision is great though, he spots things that I don't even see like airplanes or when the moon first comes out. And its not allergies because he's been on Zyrtec for over a year.
He also hasn't been sleeping well for the past week when he started feeling crummy. This kid is usually a 10-11 hour sleeper and a 2.5 hr nap. Lastnight he tossed and turned and moaned a little. I'm afraid it's his head hurting but he doesn't say it and I don't want to ask. I assume that if his head is hurting in the night he would say that it hurt. Also our pediatrician said he had a perfectly normal neuro exam and when she has seen kids with brain rumors they usually have a neuro sign like weakness in a hand or they scream from head pain. She thinks his problem sleeping is related to his constipation and bad bowel habits. He usually goes every 3 days but I gave him a glycerin enema today because it was 5 days. Never says his stomach bothers him in his sleep though.
Can I rest in knowing he doesn't have a mass in his brain? Am I looking too far into it? He only says it hurts if I ask... Maybe I should stop asking if he had pain?
Answered by Dr. Y V Siva Sankara Murty 13 minutes later

Thanks for your reply.

If a kid is asked repeatedly if his stomach hurts he will say it hurts and it is normal behavior for kids of that age. Please do not ask your child it hurts. Since the doctor said that the kid has a normal neurological examination I do not think you should worry about that.

Kids may not continue those long hours of sleep and it gradually decreases with age.

The constipation he is having should be definitely rectified. He should not require a enema in future.

Give him a diet XXXXXXX in fruits and vegetables XXXXXXX in fiber.
Avoid all the junk food he might be having. Avoid colas, chips, sweets etc .
Give him plenty of water to drink.
Encourage him to play a lot and not sit in front of the TV or computer.

Hope this helps.
Take care.
Above answer was peer-reviewed by
Follow-up: Child is feeling week and tired. Test done for wbc, monocytes level. Are the findings normal? 30 minutes later
Thanks for your reply, ill answer in order:

Head; sometimes if he is being quiet ill ask if he hurts anywhere, I never say a body part in particular, I let him tell me. And that's what worried me, he has never said head before and he said it yesterday and today.

Sleep; he had been tossing and turning and not getting good sleep. It hasn't been gradual but it started last week when he started feeling bad. Could this be because of constipation?

Constipation; he has been on miralax for 2 months. We have tried to adjust the amount so he goes often but it's been tricky. Our dr said he needs to go once a day so we are increasing it and maybe finding another solution like mineral oil. I've only given him an enema 2 times. Once was a couple months ago and he was 7 days into it, and today I did it because it was the 5th day and I was hoping he could get a good nights sleep with an empty belly.

Diet; he eats gluten free because my wife has celiac. We plan on getting him tested next year when he can be more specific with telling us if something is wrong or his belly hurrying. He is a big guy, always been off the charts in his height and is 40lbs. He eats very well with a diet consisting of mostly fruit. He's never had fried food and has only had potatoe chips a few times during the summer. He drinks watered down XXXXXXX juice mostly, about 2oz juice mix with 10oz water. I cannot for the life of me tell you why he doesn't poop. Favorite foods are blue berries, grapes and strawberries.

We play and usually tv is on. He usually plays more but energy has been low for a week now.

I just want my little guy back; if this is a virus it should be gone by next week hopefully....
Answered by Dr. Y V Siva Sankara Murty 29 minutes later

Thanks for your reply.

If a kid of that age is asked if some part of the body hurts he is most likely to answer the part of the body which he knows. So that answer may not be relied upon. A under three year old can be really considered to be in pain only when he is crying because of that pain or he is not playing and active because of pain.

That turning and tossing in sleep could be because of colic or upper respiratory infection like cold etc.

If he continues to be having constipation despite a very good fiber diet, exercises and water he should be investigated for the cause of it. Laxatives, enemas etc are only symptomatic treatment.

Hope this helps.
Take care.
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