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Has Low Neutrophil Count, CBC Counts Vary And Platelet Count Has Decreased From 350 To 230. Should I Be Worried?

Posted on Wed, 25 Sep 2013

Question: My 4 year old daughter has low neutrophil count which in the range of 100 - 1000 and changes from week to week. Sick kids has completed a smear test and do suspect and cancers. She is a fairly healthy girl, they are trying to rule out cyclical netrophina at this point. I am very worried as it has been over 2months and there is no diagnosis. Also her CBC counts vary and the platlet count has decreased from 350 to 230 which is still normal ..but why the decrease .. I am very worried.

Answered by Dr. Indranil Ghosh (12 hours later)

Hi
Thanks for your query. I understand your concern. If neutrophils are the only problem and plat and hemoglobin are fine, then cyclic neutropenia is definitely a possibility. It is a hereditary condition (parents may be normal) and fortunately follows a benign course. Patients do well with periodic injections of GCSF to boost neutrophil counts. Possibility of blood cancer is low but may be ruled out by a bone marrow exam. Other possibilities are recent infections or some drug intake. These resolve with time.

Hope I have answered your query. I will be available to answer further followup queries, if any.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (14 minutes later)

she very low neutrophil counts ranging from 100 -900 on any given day. during a regular blood test she had a count of 90, we were concerned and took her sick kids ... normally she is very energetic and a healthy little girl. they said they completed a smear test and all the cells produced seem to be mature and the right shape. they do not suspect cancer. they are testing for cyclical neutrophnia right now as her counts seems to be very low for the past couple of months. I have been monitoring her lab reports and although her playlets are normal they seem to be steadily dropping for the past month from 330 to 230 .. should I be concerned. she had a fever but was controlled within a day and we went to the hospital where blood was drawn and neutrophils were at 900 at whcih time the doctors sent us home. I am worried

Answered by Dr. Indranil Ghosh (3 minutes later)

yes, it appears to be cyclic neutropenia. platelet counts are still quite okay and you need not worry about that at this point of time. 900 neutrophil count is low but not XXXXXXX and she can be managed at home if no other problems are there. I am sure sick kids will take good care of her.
regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (24 minutes later)

should I be asking for a bone marrow aspiration. Please advise

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
Can be deferred for now

Detailed Answer:
You can hold it for now. If the hemoglobin or platelets fall then the docs may do it. Otherwise no urgent need now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (1 hour later)

Thanks .. she completed anothe CBC today and platelets are up to 250 and the lymphocyte is up to 2700 and Hemo 108. The fever is gone. however neutrophil count has dropped to 100.

Answered by Dr. Indranil Ghosh (9 hours later)

it appears more like cyclic neutropenia to me now. Hope she will recover soon!

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar