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Hi, I Have 2 Years Old Son. Recently We Noticed
Question: Hi, I have 2 years old son. Recently we noticed that his palm and face were looking yellow to us. upon online consultation we have him checked for CBC and LFT. In his reports his AST ALT ratio is exceptionally high 2.67 and his whole WBC panel is low. I am uploading his reports . He doesn't have any other symptoms which we can notice. One time his mother notices one nodes like at his neck but which also is not very visible all times. His eyes are white. kindly provide reply in details . 1. What are the reasons for his AST/ALT ratio 2. What are the reasons for his low WBC panel TLC is 3.90 (range is 4 to 15) RBC is 6. 27 neutrophills are 0.34 only ((1.5 to 8) Lymphocytes are 3.39 (6 - 9) monocytes 0.17 (.2 to 1) eosinophills and basophills are zero. His platelates are 368. Kindly provide reply in detials, U an thalassamia minor by the way.
Hi, I have 2 years old son. Recently we noticed that his palm and face were looking yellow to us. upon online consultation we have him checked for CBC and LFT. In his reports his AST ALT ratio is exceptionally high 2.67 and his whole WBC panel is low. I am uploading his reports . He doesn't have any other symptoms which we can notice. One time his mother notices one nodes like at his neck but which also is not very visible all times. His eyes are white. kindly provide reply in details . 1. What are the reasons for his AST/ALT ratio 2. What are the reasons for his low WBC panel TLC is 3.90 (range is 4 to 15) RBC is 6. 27 neutrophills are 0.34 only ((1.5 to 8) Lymphocytes are 3.39 (6 - 9) monocytes 0.17 (.2 to 1) eosinophills and basophills are zero. His platelates are 368. Kindly provide reply in detials, U an thalassamia minor by the way.
Brief Answer:
Don't worry, Will need a repeat test for Complete blood count
Detailed Answer:
Hi
Thanks for asking on this platform
I have gone through the details and do understand your concern.
In image the yellowish discoloration of palms and soles is quite obvious. It's good to know that you noticed it and got tested for same.
But again yellowish discoloration of only palms and soles only does not fullfil the criteria for jaundice.
In jaundice there is increased level of bilirubin which causes yellowish discoloration of plams, soles, skin, eyes, urine etc.
------In your baby only palm and soles are yellow, which is highly unlikely in jaundice ( although it sounds weired but I have seen such cases due to unknown exposure to any coloring agents and this gets cleard gradually itself).
The increase in bilirubin level(jaundice) can be due to liver disease(deranged liver function leads to increased bilirubin and enzymes, AST/ALT) or blood disorder (increased red cell damage causes increase in bilirubin level with normal enzymes and decreased level of hemoglobin/RBCs).
-----In your baby bilirubin level is normal which rules out jaundice again.
AST in an enzyme which is not specific for liver as it is present in skeletal muscles, cardiac muscles, red blood cells etc and can be increased in many other disorders; while ALT is present mainly in liver cells and thus more specific for liver disease.
In most of the liver disorders the enzymes level are high.
-----In your baby's report values are within normal limit.
Now coming to AST/ALT ratio..
Ideally the value should be less than 1 but here it is more than 2. Now the value of this ratio is only significant if any or both enzyme levels are increased.
Value more than 2 can be there in alcoholic liver disease(not applicable here) or chronic advanced liver disease (now this is also ruled out as there are no other features of advanced liver disease like swelling of body, uncontrolled bleeding etc.)
SO I WON'T GET OVERLY WORRIED FOR ALL THESE VALUES.
The only thing which is little worrisome is low neutrophil count.
Total count of 3900 which is borderline low with low neutrophils can be there is some viral infection. But there is not any history suggestive of viral infection.
So here I would like to get one reapet complete blood count test done, may be after 14 days.
Many a times there can be transient change in blood values or there can be lab /sampling error.
Don't get worried for small lymph nodes as that is also a normal finding for this age.
Hemoglobin value is normal so no need to worry about thalassemia.
Low MCV, MCH and MCHC with high RDW can be due to some iron deficiency. Please get one iron study test done to check iron deficiency.
Please get a repeat CBC test done and let me know if any abnormality is there.
I hope this helps.
I shall be glad to help further if you need any.
Thanks and regards
Don't worry, Will need a repeat test for Complete blood count
Detailed Answer:
Hi
Thanks for asking on this platform
I have gone through the details and do understand your concern.
In image the yellowish discoloration of palms and soles is quite obvious. It's good to know that you noticed it and got tested for same.
But again yellowish discoloration of only palms and soles only does not fullfil the criteria for jaundice.
In jaundice there is increased level of bilirubin which causes yellowish discoloration of plams, soles, skin, eyes, urine etc.
------In your baby only palm and soles are yellow, which is highly unlikely in jaundice ( although it sounds weired but I have seen such cases due to unknown exposure to any coloring agents and this gets cleard gradually itself).
The increase in bilirubin level(jaundice) can be due to liver disease(deranged liver function leads to increased bilirubin and enzymes, AST/ALT) or blood disorder (increased red cell damage causes increase in bilirubin level with normal enzymes and decreased level of hemoglobin/RBCs).
-----In your baby bilirubin level is normal which rules out jaundice again.
AST in an enzyme which is not specific for liver as it is present in skeletal muscles, cardiac muscles, red blood cells etc and can be increased in many other disorders; while ALT is present mainly in liver cells and thus more specific for liver disease.
In most of the liver disorders the enzymes level are high.
-----In your baby's report values are within normal limit.
Now coming to AST/ALT ratio..
Ideally the value should be less than 1 but here it is more than 2. Now the value of this ratio is only significant if any or both enzyme levels are increased.
Value more than 2 can be there in alcoholic liver disease(not applicable here) or chronic advanced liver disease (now this is also ruled out as there are no other features of advanced liver disease like swelling of body, uncontrolled bleeding etc.)
SO I WON'T GET OVERLY WORRIED FOR ALL THESE VALUES.
The only thing which is little worrisome is low neutrophil count.
Total count of 3900 which is borderline low with low neutrophils can be there is some viral infection. But there is not any history suggestive of viral infection.
So here I would like to get one reapet complete blood count test done, may be after 14 days.
Many a times there can be transient change in blood values or there can be lab /sampling error.
Don't get worried for small lymph nodes as that is also a normal finding for this age.
Hemoglobin value is normal so no need to worry about thalassemia.
Low MCV, MCH and MCHC with high RDW can be due to some iron deficiency. Please get one iron study test done to check iron deficiency.
Please get a repeat CBC test done and let me know if any abnormality is there.
I hope this helps.
I shall be glad to help further if you need any.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Don't worry, Will need a repeat test for Complete blood count
Detailed Answer:
Hi
Thanks for asking on this platform
I have gone through the details and do understand your concern.
In image the yellowish discoloration of palms and soles is quite obvious. It's good to know that you noticed it and got tested for same.
But again yellowish discoloration of only palms and soles only does not fullfil the criteria for jaundice.
In jaundice there is increased level of bilirubin which causes yellowish discoloration of plams, soles, skin, eyes, urine etc.
------In your baby only palm and soles are yellow, which is highly unlikely in jaundice ( although it sounds weired but I have seen such cases due to unknown exposure to any coloring agents and this gets cleard gradually itself).
The increase in bilirubin level(jaundice) can be due to liver disease(deranged liver function leads to increased bilirubin and enzymes, AST/ALT) or blood disorder (increased red cell damage causes increase in bilirubin level with normal enzymes and decreased level of hemoglobin/RBCs).
-----In your baby bilirubin level is normal which rules out jaundice again.
AST in an enzyme which is not specific for liver as it is present in skeletal muscles, cardiac muscles, red blood cells etc and can be increased in many other disorders; while ALT is present mainly in liver cells and thus more specific for liver disease.
In most of the liver disorders the enzymes level are high.
-----In your baby's report values are within normal limit.
Now coming to AST/ALT ratio..
Ideally the value should be less than 1 but here it is more than 2. Now the value of this ratio is only significant if any or both enzyme levels are increased.
Value more than 2 can be there in alcoholic liver disease(not applicable here) or chronic advanced liver disease (now this is also ruled out as there are no other features of advanced liver disease like swelling of body, uncontrolled bleeding etc.)
SO I WON'T GET OVERLY WORRIED FOR ALL THESE VALUES.
The only thing which is little worrisome is low neutrophil count.
Total count of 3900 which is borderline low with low neutrophils can be there is some viral infection. But there is not any history suggestive of viral infection.
So here I would like to get one reapet complete blood count test done, may be after 14 days.
Many a times there can be transient change in blood values or there can be lab /sampling error.
Don't get worried for small lymph nodes as that is also a normal finding for this age.
Hemoglobin value is normal so no need to worry about thalassemia.
Low MCV, MCH and MCHC with high RDW can be due to some iron deficiency. Please get one iron study test done to check iron deficiency.
Please get a repeat CBC test done and let me know if any abnormality is there.
I hope this helps.
I shall be glad to help further if you need any.
Thanks and regards
Don't worry, Will need a repeat test for Complete blood count
Detailed Answer:
Hi
Thanks for asking on this platform
I have gone through the details and do understand your concern.
In image the yellowish discoloration of palms and soles is quite obvious. It's good to know that you noticed it and got tested for same.
But again yellowish discoloration of only palms and soles only does not fullfil the criteria for jaundice.
In jaundice there is increased level of bilirubin which causes yellowish discoloration of plams, soles, skin, eyes, urine etc.
------In your baby only palm and soles are yellow, which is highly unlikely in jaundice ( although it sounds weired but I have seen such cases due to unknown exposure to any coloring agents and this gets cleard gradually itself).
The increase in bilirubin level(jaundice) can be due to liver disease(deranged liver function leads to increased bilirubin and enzymes, AST/ALT) or blood disorder (increased red cell damage causes increase in bilirubin level with normal enzymes and decreased level of hemoglobin/RBCs).
-----In your baby bilirubin level is normal which rules out jaundice again.
AST in an enzyme which is not specific for liver as it is present in skeletal muscles, cardiac muscles, red blood cells etc and can be increased in many other disorders; while ALT is present mainly in liver cells and thus more specific for liver disease.
In most of the liver disorders the enzymes level are high.
-----In your baby's report values are within normal limit.
Now coming to AST/ALT ratio..
Ideally the value should be less than 1 but here it is more than 2. Now the value of this ratio is only significant if any or both enzyme levels are increased.
Value more than 2 can be there in alcoholic liver disease(not applicable here) or chronic advanced liver disease (now this is also ruled out as there are no other features of advanced liver disease like swelling of body, uncontrolled bleeding etc.)
SO I WON'T GET OVERLY WORRIED FOR ALL THESE VALUES.
The only thing which is little worrisome is low neutrophil count.
Total count of 3900 which is borderline low with low neutrophils can be there is some viral infection. But there is not any history suggestive of viral infection.
So here I would like to get one reapet complete blood count test done, may be after 14 days.
Many a times there can be transient change in blood values or there can be lab /sampling error.
Don't get worried for small lymph nodes as that is also a normal finding for this age.
Hemoglobin value is normal so no need to worry about thalassemia.
Low MCV, MCH and MCHC with high RDW can be due to some iron deficiency. Please get one iron study test done to check iron deficiency.
Please get a repeat CBC test done and let me know if any abnormality is there.
I hope this helps.
I shall be glad to help further if you need any.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hello doctor it may sound little paranoia but due to bad habit of googling what I have read iss that that much less neutrophils less than 500 are mostly associated with cancer, blood related or bone marrow related or other dreadful auto immune disease. Can viral infection cause such low neutrophils count, and if so for how long time. what are likelihood etc. as both ratio and low WBC are giving additional stress. Thanks for detailed reply.
Hello doctor it may sound little paranoia but due to bad habit of googling what I have read iss that that much less neutrophils less than 500 are mostly associated with cancer, blood related or bone marrow related or other dreadful auto immune disease. Can viral infection cause such low neutrophils count, and if so for how long time. what are likelihood etc. as both ratio and low WBC are giving additional stress. Thanks for detailed reply.
Brief Answer:
Don't worry much, please get CBC done after 14 days
Detailed Answer:
Hi
Thanks for follow up
I can understand your concern.
You have collected right information about causes of neutropenia.
But as I told you earlier that a single report in absence of any significant symptoms might be fallacious.
In medical field one has to correlate the reports with clinical symptoms. It's true that neutrophil below 500 is a serious issue but not in your case. Bone marrow suppression is suspected when at least two cell lines(any of WBC, RBC or Platelets) are depressed. Here apart from WBC other parameters are within normal range.
I have seen many cases with first report showing deranged value which comes normal when we repeat that.
So don't worry unless the repeat test shows the same finding.
Regarding altered ratio of liver enzymes I can assure you that the function of liver is normal and you need not to worry at all.
Please feel free to ask if you have any more doubts.
Regards
Don't worry much, please get CBC done after 14 days
Detailed Answer:
Hi
Thanks for follow up
I can understand your concern.
You have collected right information about causes of neutropenia.
But as I told you earlier that a single report in absence of any significant symptoms might be fallacious.
In medical field one has to correlate the reports with clinical symptoms. It's true that neutrophil below 500 is a serious issue but not in your case. Bone marrow suppression is suspected when at least two cell lines(any of WBC, RBC or Platelets) are depressed. Here apart from WBC other parameters are within normal range.
I have seen many cases with first report showing deranged value which comes normal when we repeat that.
So don't worry unless the repeat test shows the same finding.
Regarding altered ratio of liver enzymes I can assure you that the function of liver is normal and you need not to worry at all.
Please feel free to ask if you have any more doubts.
Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Don't worry much, please get CBC done after 14 days
Detailed Answer:
Hi
Thanks for follow up
I can understand your concern.
You have collected right information about causes of neutropenia.
But as I told you earlier that a single report in absence of any significant symptoms might be fallacious.
In medical field one has to correlate the reports with clinical symptoms. It's true that neutrophil below 500 is a serious issue but not in your case. Bone marrow suppression is suspected when at least two cell lines(any of WBC, RBC or Platelets) are depressed. Here apart from WBC other parameters are within normal range.
I have seen many cases with first report showing deranged value which comes normal when we repeat that.
So don't worry unless the repeat test shows the same finding.
Regarding altered ratio of liver enzymes I can assure you that the function of liver is normal and you need not to worry at all.
Please feel free to ask if you have any more doubts.
Regards
Don't worry much, please get CBC done after 14 days
Detailed Answer:
Hi
Thanks for follow up
I can understand your concern.
You have collected right information about causes of neutropenia.
But as I told you earlier that a single report in absence of any significant symptoms might be fallacious.
In medical field one has to correlate the reports with clinical symptoms. It's true that neutrophil below 500 is a serious issue but not in your case. Bone marrow suppression is suspected when at least two cell lines(any of WBC, RBC or Platelets) are depressed. Here apart from WBC other parameters are within normal range.
I have seen many cases with first report showing deranged value which comes normal when we repeat that.
So don't worry unless the repeat test shows the same finding.
Regarding altered ratio of liver enzymes I can assure you that the function of liver is normal and you need not to worry at all.
Please feel free to ask if you have any more doubts.
Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi doctor my son skin is pale or yellow for sure, and can be observed easily when we are sitting with him. Having my son give blood was very issuable last time and had to take him to emergency room bed this time too because he was not cooperating . Will have to wait till lockdown because hospital are source of infection and will ask back again. Jibone more thing can viral infection cause such neutropenia,? Have you seen such cases where WBC got low due to viral infections.Thanks and Regards
Hi doctor my son skin is pale or yellow for sure, and can be observed easily when we are sitting with him. Having my son give blood was very issuable last time and had to take him to emergency room bed this time too because he was not cooperating . Will have to wait till lockdown because hospital are source of infection and will ask back again. Jibone more thing can viral infection cause such neutropenia,? Have you seen such cases where WBC got low due to viral infections.Thanks and Regards
Brief Answer:
Yes viral infections can cause such neutropenia
Detailed Answer:
Hi
Thanks for follow up
I agree. In present scenario, it's better to stay at home unless some significant problem is there.
Yes, viral infections can cause such extent of neutropenia.
Don't worry much.
You may always clear your doubts or also get a second opinion if needed here on Healthcare magic.
If really any significant health related issues please consult your nearest emergency.
Wishing for good health of your family.
Thanks and Regards
Yes viral infections can cause such neutropenia
Detailed Answer:
Hi
Thanks for follow up
I agree. In present scenario, it's better to stay at home unless some significant problem is there.
Yes, viral infections can cause such extent of neutropenia.
Don't worry much.
You may always clear your doubts or also get a second opinion if needed here on Healthcare magic.
If really any significant health related issues please consult your nearest emergency.
Wishing for good health of your family.
Thanks and Regards
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
Yes viral infections can cause such neutropenia
Detailed Answer:
Hi
Thanks for follow up
I agree. In present scenario, it's better to stay at home unless some significant problem is there.
Yes, viral infections can cause such extent of neutropenia.
Don't worry much.
You may always clear your doubts or also get a second opinion if needed here on Healthcare magic.
If really any significant health related issues please consult your nearest emergency.
Wishing for good health of your family.
Thanks and Regards
Yes viral infections can cause such neutropenia
Detailed Answer:
Hi
Thanks for follow up
I agree. In present scenario, it's better to stay at home unless some significant problem is there.
Yes, viral infections can cause such extent of neutropenia.
Don't worry much.
You may always clear your doubts or also get a second opinion if needed here on Healthcare magic.
If really any significant health related issues please consult your nearest emergency.
Wishing for good health of your family.
Thanks and Regards
Above answer was peer-reviewed by :
Dr. Prasad
Hi doctor, we have repeated his CBC LFT KFT HEP Viral marks, and electrophoresis. I am uploading new reports 9f CBC and LFT KFT . His neutrophiles are 4.3 in new report, and 40 percentage, but lymphocytes are 6.7 in absolute count, and 58 percentage. His lab person told that for children it's should be normal. Is this report normal, means wrt to leukemia like disease. They told his smear report is normal , but they haven't given me, I will upload shortly.He is thalassamia minor as per them, but they haven't uploaded that report too. Is this true for children range is different, and it's not risky having 6.7 absolute count of lymphocytes, because in earlier lal path report reference range was 6 to 9 for lymphocytes but in present report it's very low reference range. Kindly guide. 2. His AST ALT ratio is kind of same , still high, touching 2 now, earlier was 2.67, so little less. As per me his skin colour is getting better. I have him tested for Hep infection and as per lab person report are negative, will upload shortly. Your opinion about seriousness. 3. In KFT his urea is high. Possible connection or reason. please give detail answer and your opinion, I just want to clear off serious disease, really panicked for baby. But please give your opinion without giving look to my panick level Thanks
Hi doctor, we have repeated his CBC LFT KFT HEP Viral marks, and electrophoresis. I am uploading new reports 9f CBC and LFT KFT . His neutrophiles are 4.3 in new report, and 40 percentage, but lymphocytes are 6.7 in absolute count, and 58 percentage. His lab person told that for children it's should be normal. Is this report normal, means wrt to leukemia like disease. They told his smear report is normal , but they haven't given me, I will upload shortly.He is thalassamia minor as per them, but they haven't uploaded that report too. Is this true for children range is different, and it's not risky having 6.7 absolute count of lymphocytes, because in earlier lal path report reference range was 6 to 9 for lymphocytes but in present report it's very low reference range. Kindly guide. 2. His AST ALT ratio is kind of same , still high, touching 2 now, earlier was 2.67, so little less. As per me his skin colour is getting better. I have him tested for Hep infection and as per lab person report are negative, will upload shortly. Your opinion about seriousness. 3. In KFT his urea is high. Possible connection or reason. please give detail answer and your opinion, I just want to clear off serious disease, really panicked for baby. But please give your opinion without giving look to my panick level Thanks
I have uploaded all the reports. Kindly give detailed reply.
I have uploaded all the reports. Kindly give detailed reply.
Brief Answer:
Lymphocytes are normal for age, don't worry for enzymes
Detailed Answer:
Hi
Thanks for follow up
I have see all the reports and it is suggestive of thalassemia minor. Other values are normal.
The lab person is right as the lymphocyte percentage as for this age is normal. Children of this age are in lymph proliferative phase and lymphocyte counts are more as compare to adults.
As said earlier I won't get worried for enzyme values and ratio as it has no significance. Mch, MCHC and MCV values were low with raised RDW in previous report but the iron study is also normal so iron deficiency is also ruled out.
In kidney function test it is the creatinine which is more specific not urea. Urea can be high due to so many causes and most common is dehydration. So I won't get worried if creatinine is normal and child is passing urine well. Give him plenty of fluids to keep well hydrated.
I don't find any reason to worry for.
In this current situation of COVID crisis, I would suggest you to stay home and not to worry at all. Please don't run behind the tests and avoid unnecessary exposure to outside person.
Please keep me updated about the pending reports (no need of any new test) . I will try my best to clear all your doubts.
Stay home, stay healthy.
With regards
Lymphocytes are normal for age, don't worry for enzymes
Detailed Answer:
Hi
Thanks for follow up
I have see all the reports and it is suggestive of thalassemia minor. Other values are normal.
The lab person is right as the lymphocyte percentage as for this age is normal. Children of this age are in lymph proliferative phase and lymphocyte counts are more as compare to adults.
As said earlier I won't get worried for enzyme values and ratio as it has no significance. Mch, MCHC and MCV values were low with raised RDW in previous report but the iron study is also normal so iron deficiency is also ruled out.
In kidney function test it is the creatinine which is more specific not urea. Urea can be high due to so many causes and most common is dehydration. So I won't get worried if creatinine is normal and child is passing urine well. Give him plenty of fluids to keep well hydrated.
I don't find any reason to worry for.
In this current situation of COVID crisis, I would suggest you to stay home and not to worry at all. Please don't run behind the tests and avoid unnecessary exposure to outside person.
Please keep me updated about the pending reports (no need of any new test) . I will try my best to clear all your doubts.
Stay home, stay healthy.
With regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Lymphocytes are normal for age, don't worry for enzymes
Detailed Answer:
Hi
Thanks for follow up
I have see all the reports and it is suggestive of thalassemia minor. Other values are normal.
The lab person is right as the lymphocyte percentage as for this age is normal. Children of this age are in lymph proliferative phase and lymphocyte counts are more as compare to adults.
As said earlier I won't get worried for enzyme values and ratio as it has no significance. Mch, MCHC and MCV values were low with raised RDW in previous report but the iron study is also normal so iron deficiency is also ruled out.
In kidney function test it is the creatinine which is more specific not urea. Urea can be high due to so many causes and most common is dehydration. So I won't get worried if creatinine is normal and child is passing urine well. Give him plenty of fluids to keep well hydrated.
I don't find any reason to worry for.
In this current situation of COVID crisis, I would suggest you to stay home and not to worry at all. Please don't run behind the tests and avoid unnecessary exposure to outside person.
Please keep me updated about the pending reports (no need of any new test) . I will try my best to clear all your doubts.
Stay home, stay healthy.
With regards
Lymphocytes are normal for age, don't worry for enzymes
Detailed Answer:
Hi
Thanks for follow up
I have see all the reports and it is suggestive of thalassemia minor. Other values are normal.
The lab person is right as the lymphocyte percentage as for this age is normal. Children of this age are in lymph proliferative phase and lymphocyte counts are more as compare to adults.
As said earlier I won't get worried for enzyme values and ratio as it has no significance. Mch, MCHC and MCV values were low with raised RDW in previous report but the iron study is also normal so iron deficiency is also ruled out.
In kidney function test it is the creatinine which is more specific not urea. Urea can be high due to so many causes and most common is dehydration. So I won't get worried if creatinine is normal and child is passing urine well. Give him plenty of fluids to keep well hydrated.
I don't find any reason to worry for.
In this current situation of COVID crisis, I would suggest you to stay home and not to worry at all. Please don't run behind the tests and avoid unnecessary exposure to outside person.
Please keep me updated about the pending reports (no need of any new test) . I will try my best to clear all your doubts.
Stay home, stay healthy.
With regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi, doctor Thanks for reply. Its very big relief for me. 1 . One query I have that in earlier Lal path lab report, Reference for lymphocyte and Neutrophiles absolute count was 6 to 9 for lymphocyte and 1.5 to 8 for neutrophiles. While in present lab (Narang Lab which has good reviews of user) Reference for lymphocytes is 0.8 to 2.8 only and ayansh Lymphocyte value is 6.7 , so is not this value 6.7 is high by their own Reference range of particular test. Their Reference range is till 2.8 only and his value is 6.7, although they are saying for children it's normal. Very confusing. 2. How long will it take him to cover and revert back AST ALT ratio to normal, because he became yellow and now improved a lot from there. So if something was there, will it resolved by itself with precautions. Since cause is not very clear, so any precautions in diet smt. 3. With Thalassamia beta trait , are his symptoms are related? I also have, I always had HB count lesser than normal but never noticed until one Doctor noticed and had me for electrophoresis test. I don't remember having such yellowness. 4. If creatin value had to rise , would have risen in such days gap? So that there should not remain any fear of rising it in following days? Thanks for very valuable and thoroughly explanations. Thanks and Regards
Hi, doctor Thanks for reply. Its very big relief for me. 1 . One query I have that in earlier Lal path lab report, Reference for lymphocyte and Neutrophiles absolute count was 6 to 9 for lymphocyte and 1.5 to 8 for neutrophiles. While in present lab (Narang Lab which has good reviews of user) Reference for lymphocytes is 0.8 to 2.8 only and ayansh Lymphocyte value is 6.7 , so is not this value 6.7 is high by their own Reference range of particular test. Their Reference range is till 2.8 only and his value is 6.7, although they are saying for children it's normal. Very confusing. 2. How long will it take him to cover and revert back AST ALT ratio to normal, because he became yellow and now improved a lot from there. So if something was there, will it resolved by itself with precautions. Since cause is not very clear, so any precautions in diet smt. 3. With Thalassamia beta trait , are his symptoms are related? I also have, I always had HB count lesser than normal but never noticed until one Doctor noticed and had me for electrophoresis test. I don't remember having such yellowness. 4. If creatin value had to rise , would have risen in such days gap? So that there should not remain any fear of rising it in following days? Thanks for very valuable and thoroughly explanations. Thanks and Regards
Brief Answer:
Again I would tell you not to worry as reports are normal
Detailed Answer:
Hi sir
Welcome again
If case of any doubt, you are always welcome.
I would like to tell you that any doctor has to correlate clinical and laboratory finding before coming to any conclusion.
Here I agree with the lab person of XXXXXXX laboratory that the relative lymphocyte count is normally higher in this age because of lymph proliferative phase. You can check the age related reference values online.
Most of the laboratories don't follow the guidelines and that is the reason they just use one common Performa and don't give age related references. The same is applicable to both XXXXXXX and Dr lals path. XXXXXXX path lab has not given the age related reference values and lal path has mentioned alcoholic liver disease as an interpretation for altered enzymes ratio which is not applicable for 2 years old. So finally a doctor has to take a call about the history given by parents, clinical picture, lab values and all.
Now coming to your second doubt..
No need to worry about enzyme ratio as the values are within normal limit. Already explained in detail.
Third..
Apart from borderline hemoglobin value and electrophoresis nothing is related to thalassemia.
Just observe the yellowish discoloration. I don't find any reason to worry about.
Fourth..
Again, no need to worry about urea value. Just keep him well hydrated. Observe for urinary frequency. No need to repeat the test if there is no related symptoms.
In summary.. Don't worry.. Give plenty of fluids.. Observe for yellowish discoloration..
Please write me back if you have any doubt.
Regards
Again I would tell you not to worry as reports are normal
Detailed Answer:
Hi sir
Welcome again
If case of any doubt, you are always welcome.
I would like to tell you that any doctor has to correlate clinical and laboratory finding before coming to any conclusion.
Here I agree with the lab person of XXXXXXX laboratory that the relative lymphocyte count is normally higher in this age because of lymph proliferative phase. You can check the age related reference values online.
Most of the laboratories don't follow the guidelines and that is the reason they just use one common Performa and don't give age related references. The same is applicable to both XXXXXXX and Dr lals path. XXXXXXX path lab has not given the age related reference values and lal path has mentioned alcoholic liver disease as an interpretation for altered enzymes ratio which is not applicable for 2 years old. So finally a doctor has to take a call about the history given by parents, clinical picture, lab values and all.
Now coming to your second doubt..
No need to worry about enzyme ratio as the values are within normal limit. Already explained in detail.
Third..
Apart from borderline hemoglobin value and electrophoresis nothing is related to thalassemia.
Just observe the yellowish discoloration. I don't find any reason to worry about.
Fourth..
Again, no need to worry about urea value. Just keep him well hydrated. Observe for urinary frequency. No need to repeat the test if there is no related symptoms.
In summary.. Don't worry.. Give plenty of fluids.. Observe for yellowish discoloration..
Please write me back if you have any doubt.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Again I would tell you not to worry as reports are normal
Detailed Answer:
Hi sir
Welcome again
If case of any doubt, you are always welcome.
I would like to tell you that any doctor has to correlate clinical and laboratory finding before coming to any conclusion.
Here I agree with the lab person of XXXXXXX laboratory that the relative lymphocyte count is normally higher in this age because of lymph proliferative phase. You can check the age related reference values online.
Most of the laboratories don't follow the guidelines and that is the reason they just use one common Performa and don't give age related references. The same is applicable to both XXXXXXX and Dr lals path. XXXXXXX path lab has not given the age related reference values and lal path has mentioned alcoholic liver disease as an interpretation for altered enzymes ratio which is not applicable for 2 years old. So finally a doctor has to take a call about the history given by parents, clinical picture, lab values and all.
Now coming to your second doubt..
No need to worry about enzyme ratio as the values are within normal limit. Already explained in detail.
Third..
Apart from borderline hemoglobin value and electrophoresis nothing is related to thalassemia.
Just observe the yellowish discoloration. I don't find any reason to worry about.
Fourth..
Again, no need to worry about urea value. Just keep him well hydrated. Observe for urinary frequency. No need to repeat the test if there is no related symptoms.
In summary.. Don't worry.. Give plenty of fluids.. Observe for yellowish discoloration..
Please write me back if you have any doubt.
Regards
Again I would tell you not to worry as reports are normal
Detailed Answer:
Hi sir
Welcome again
If case of any doubt, you are always welcome.
I would like to tell you that any doctor has to correlate clinical and laboratory finding before coming to any conclusion.
Here I agree with the lab person of XXXXXXX laboratory that the relative lymphocyte count is normally higher in this age because of lymph proliferative phase. You can check the age related reference values online.
Most of the laboratories don't follow the guidelines and that is the reason they just use one common Performa and don't give age related references. The same is applicable to both XXXXXXX and Dr lals path. XXXXXXX path lab has not given the age related reference values and lal path has mentioned alcoholic liver disease as an interpretation for altered enzymes ratio which is not applicable for 2 years old. So finally a doctor has to take a call about the history given by parents, clinical picture, lab values and all.
Now coming to your second doubt..
No need to worry about enzyme ratio as the values are within normal limit. Already explained in detail.
Third..
Apart from borderline hemoglobin value and electrophoresis nothing is related to thalassemia.
Just observe the yellowish discoloration. I don't find any reason to worry about.
Fourth..
Again, no need to worry about urea value. Just keep him well hydrated. Observe for urinary frequency. No need to repeat the test if there is no related symptoms.
In summary.. Don't worry.. Give plenty of fluids.. Observe for yellowish discoloration..
Please write me back if you have any doubt.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi, Doctor Thanks for reply. 1. You said that no need to repeat the test if there are no related symptoms? What symptoms you are referring? Could you please explain. 2. Why still there is space for ambiguity, like symptoms may or may not appear, are his symptoms and values are in vague area. I am in comfort zone after hearing your reply that report are normal, but then again a clause to observe his symptoms is there. Why aren't we 100 percentage clear or close to clear. Sorry for Paranoia. 3 I believe he is having thalassamia beta triat. Are there any issues related with that, like health complications. If only one parent is carrier than I think he can't become major . Thanks
Hi, Doctor Thanks for reply. 1. You said that no need to repeat the test if there are no related symptoms? What symptoms you are referring? Could you please explain. 2. Why still there is space for ambiguity, like symptoms may or may not appear, are his symptoms and values are in vague area. I am in comfort zone after hearing your reply that report are normal, but then again a clause to observe his symptoms is there. Why aren't we 100 percentage clear or close to clear. Sorry for Paranoia. 3 I believe he is having thalassamia beta triat. Are there any issues related with that, like health complications. If only one parent is carrier than I think he can't become major . Thanks
Brief Answer:
Observation is needed for children even in normal daily routine
Detailed Answer:
Hi
I can understand your concern and its really genuine.
The only reason I said to observe because you are the best person to do that. Observation is needed as yellowish discoloration is still there. All the reports are normal so the exact cause of this yellowish discoloration is not known. Even normal children of this age need to be observed by parents. And from your observation only, this yellowish discoloration got detected. Also you only noticed persistent low/borderline value of hemoglobin and that resulted in detection of thalassemia minor. So parents are the best observer. I repeat that no need to worry but still observation is needed for progression or resolution of yellowish discoloration (chances of resolution much more as you only mentioned that it has started decreasing).
Again I suggested you to give plenty of fluid and watch for urinary frequency. This because urea value is little higher which is most likely due to dehydration and warm weather. Urinary frequency is the best way to assess dehydration status. If he passes urine 4-5 times a day, no need to worry.In hot weather even for normal child it is advised to observe for frequency of urination.
I said not to retest, in current context of Covid crisis. Unless it is really needed it is best to avoid testing and to expose your child to outsiders. In your case it is highly unlikely that the report will worsen further. That is the reason I suggested to observe and get tested only and only if symptoms worsen(like progression of yellowness or poor intake of fluid and decreased urinary frequency).
100% surity can be given only if there is no apparent yellowness.
Symptoms are not related to thalassemia and you are right if one parent is carrier then baby will be minor only.
I hope I am able to explain and clear your doubts.
If not then please tell me about your doubts.
Thanks and regards
Observation is needed for children even in normal daily routine
Detailed Answer:
Hi
I can understand your concern and its really genuine.
The only reason I said to observe because you are the best person to do that. Observation is needed as yellowish discoloration is still there. All the reports are normal so the exact cause of this yellowish discoloration is not known. Even normal children of this age need to be observed by parents. And from your observation only, this yellowish discoloration got detected. Also you only noticed persistent low/borderline value of hemoglobin and that resulted in detection of thalassemia minor. So parents are the best observer. I repeat that no need to worry but still observation is needed for progression or resolution of yellowish discoloration (chances of resolution much more as you only mentioned that it has started decreasing).
Again I suggested you to give plenty of fluid and watch for urinary frequency. This because urea value is little higher which is most likely due to dehydration and warm weather. Urinary frequency is the best way to assess dehydration status. If he passes urine 4-5 times a day, no need to worry.In hot weather even for normal child it is advised to observe for frequency of urination.
I said not to retest, in current context of Covid crisis. Unless it is really needed it is best to avoid testing and to expose your child to outsiders. In your case it is highly unlikely that the report will worsen further. That is the reason I suggested to observe and get tested only and only if symptoms worsen(like progression of yellowness or poor intake of fluid and decreased urinary frequency).
100% surity can be given only if there is no apparent yellowness.
Symptoms are not related to thalassemia and you are right if one parent is carrier then baby will be minor only.
I hope I am able to explain and clear your doubts.
If not then please tell me about your doubts.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Observation is needed for children even in normal daily routine
Detailed Answer:
Hi
I can understand your concern and its really genuine.
The only reason I said to observe because you are the best person to do that. Observation is needed as yellowish discoloration is still there. All the reports are normal so the exact cause of this yellowish discoloration is not known. Even normal children of this age need to be observed by parents. And from your observation only, this yellowish discoloration got detected. Also you only noticed persistent low/borderline value of hemoglobin and that resulted in detection of thalassemia minor. So parents are the best observer. I repeat that no need to worry but still observation is needed for progression or resolution of yellowish discoloration (chances of resolution much more as you only mentioned that it has started decreasing).
Again I suggested you to give plenty of fluid and watch for urinary frequency. This because urea value is little higher which is most likely due to dehydration and warm weather. Urinary frequency is the best way to assess dehydration status. If he passes urine 4-5 times a day, no need to worry.In hot weather even for normal child it is advised to observe for frequency of urination.
I said not to retest, in current context of Covid crisis. Unless it is really needed it is best to avoid testing and to expose your child to outsiders. In your case it is highly unlikely that the report will worsen further. That is the reason I suggested to observe and get tested only and only if symptoms worsen(like progression of yellowness or poor intake of fluid and decreased urinary frequency).
100% surity can be given only if there is no apparent yellowness.
Symptoms are not related to thalassemia and you are right if one parent is carrier then baby will be minor only.
I hope I am able to explain and clear your doubts.
If not then please tell me about your doubts.
Thanks and regards
Observation is needed for children even in normal daily routine
Detailed Answer:
Hi
I can understand your concern and its really genuine.
The only reason I said to observe because you are the best person to do that. Observation is needed as yellowish discoloration is still there. All the reports are normal so the exact cause of this yellowish discoloration is not known. Even normal children of this age need to be observed by parents. And from your observation only, this yellowish discoloration got detected. Also you only noticed persistent low/borderline value of hemoglobin and that resulted in detection of thalassemia minor. So parents are the best observer. I repeat that no need to worry but still observation is needed for progression or resolution of yellowish discoloration (chances of resolution much more as you only mentioned that it has started decreasing).
Again I suggested you to give plenty of fluid and watch for urinary frequency. This because urea value is little higher which is most likely due to dehydration and warm weather. Urinary frequency is the best way to assess dehydration status. If he passes urine 4-5 times a day, no need to worry.In hot weather even for normal child it is advised to observe for frequency of urination.
I said not to retest, in current context of Covid crisis. Unless it is really needed it is best to avoid testing and to expose your child to outsiders. In your case it is highly unlikely that the report will worsen further. That is the reason I suggested to observe and get tested only and only if symptoms worsen(like progression of yellowness or poor intake of fluid and decreased urinary frequency).
100% surity can be given only if there is no apparent yellowness.
Symptoms are not related to thalassemia and you are right if one parent is carrier then baby will be minor only.
I hope I am able to explain and clear your doubts.
If not then please tell me about your doubts.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thanks doctor, Now yellowness is almost kind of gone, like 85 or 90 percentage gone, means relatively very improved. Urine frequency is good too so far. Thanks for your consultation. One last thing, he runs on toes from beginning, as he used to stand on cot for watching outside, and calves used to get tight too. 3 or 4 months before too he used to have pain in legs as he walks or run non stop through out day. So doctor said May be growth pains or rickets, so he gave Vit D course him too , which finished recently only. Thanks for your valuable suggestions and consultantation. Thanks and Regards.
Thanks doctor, Now yellowness is almost kind of gone, like 85 or 90 percentage gone, means relatively very improved. Urine frequency is good too so far. Thanks for your consultation. One last thing, he runs on toes from beginning, as he used to stand on cot for watching outside, and calves used to get tight too. 3 or 4 months before too he used to have pain in legs as he walks or run non stop through out day. So doctor said May be growth pains or rickets, so he gave Vit D course him too , which finished recently only. Thanks for your valuable suggestions and consultantation. Thanks and Regards.
Brief Answer:
Toe walking is common unless associated with other abnormalities
Detailed Answer:
Thank u very much for detailed follow up
I am really appreciate the way you provided details in every follow up. For a doctor this is very important and not very commonly seen in online consultation.
I am glad to know that yellowness is almost gone. This is very assuring and now you need not to worry about anything.
Little bit of toe walking, pain in leg is common and not always associated with vitamin d or calcium deficiency. Most of the time it's a part of 'growing pain' and improves with age. It is not rickets for sure.
Thank u again for your kind patience and believing in me.
You can ask me further directly in case of any doubt in coming future.
I will be more than glad to help you again.
Wishing good health of baby and your whole family
Best regards
Toe walking is common unless associated with other abnormalities
Detailed Answer:
Thank u very much for detailed follow up
I am really appreciate the way you provided details in every follow up. For a doctor this is very important and not very commonly seen in online consultation.
I am glad to know that yellowness is almost gone. This is very assuring and now you need not to worry about anything.
Little bit of toe walking, pain in leg is common and not always associated with vitamin d or calcium deficiency. Most of the time it's a part of 'growing pain' and improves with age. It is not rickets for sure.
Thank u again for your kind patience and believing in me.
You can ask me further directly in case of any doubt in coming future.
I will be more than glad to help you again.
Wishing good health of baby and your whole family
Best regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Toe walking is common unless associated with other abnormalities
Detailed Answer:
Thank u very much for detailed follow up
I am really appreciate the way you provided details in every follow up. For a doctor this is very important and not very commonly seen in online consultation.
I am glad to know that yellowness is almost gone. This is very assuring and now you need not to worry about anything.
Little bit of toe walking, pain in leg is common and not always associated with vitamin d or calcium deficiency. Most of the time it's a part of 'growing pain' and improves with age. It is not rickets for sure.
Thank u again for your kind patience and believing in me.
You can ask me further directly in case of any doubt in coming future.
I will be more than glad to help you again.
Wishing good health of baby and your whole family
Best regards
Toe walking is common unless associated with other abnormalities
Detailed Answer:
Thank u very much for detailed follow up
I am really appreciate the way you provided details in every follow up. For a doctor this is very important and not very commonly seen in online consultation.
I am glad to know that yellowness is almost gone. This is very assuring and now you need not to worry about anything.
Little bit of toe walking, pain in leg is common and not always associated with vitamin d or calcium deficiency. Most of the time it's a part of 'growing pain' and improves with age. It is not rickets for sure.
Thank u again for your kind patience and believing in me.
You can ask me further directly in case of any doubt in coming future.
I will be more than glad to help you again.
Wishing good health of baby and your whole family
Best regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Doctor
I have few queries again regarding last follow up, First thing is my son age is 2.2 not exact 02 years so will it change previous opinion?
1. I just noticed that in blood smear report of my son, normhocytic normhochromc anemia is mentioned as opinion. This anemia is associated with multiple chronic dreaded diseased, cancers chronic , renel failure or less functioning and many other serious things only. I think you have considered this report too in last consultation. His BUN is high , AST ALT ratio is high so creating lot of confusion.
2. In his CBC MCV MCH etc are low, i used to have same findings so i could find. In my smear it was always microcytic anemia opinion which is due to thalessemia. Ayansh CBC is having low MCV MCH too but how come his smear opinion is normochromatic and normocytic ? His IRON studies are also included and that is normal and uploaded too , please find that too. How serious is this and why its in normochromatic range , if MCV is low. Because normochromatic is associated with malignancies , chronic feature please give detailed answer, because it has worried me again.
3. Sorry again for AST ALT ratio, I read that for child till 3 years AST range is till 60 and considered normal (doctors knows better) and ALT range is till 45. If this is true then can a child can have higher AST and low ALT in general. Does AST ALT ratio matter in child up to 03 years? In earlier opinion you said that Lal path lab was wrong in mentioning chronic cirrhosis as opinion as its not valid for child but ratio more than 2 associated with other serious issues like liver neoplasia , failure etc.
4. His yellowness is relative kind of thing, when we see him alone he looks normal but when we compared with others he looks yellow, not yellow as it was shown in pics because camera produced color saturated images, I will upload a current pic with different camera. So when I see him alone he looks alright may be a litttle yellow non noticeable to all.
5. With child range is Urea value are almost kind of double. Is this can be dehydration means we try to keep him hydrated although he resists. How much water should be given. His urine frequency is normal. We give him lentils in night daily so far, and early morning is daliya with little lentils . In day lunch daliya is repeated to avoid constipation and give him hard fibers because when we were giving him iron supplements or ocassionally he was constipated. Meantime fruits , and milk.
With this normhochromatic thing whats your opinion as again its associated with lots of dreaded things. Kindly reply for all points . Thanks and Regards.
I have few queries again regarding last follow up, First thing is my son age is 2.2 not exact 02 years so will it change previous opinion?
1. I just noticed that in blood smear report of my son, normhocytic normhochromc anemia is mentioned as opinion. This anemia is associated with multiple chronic dreaded diseased, cancers chronic , renel failure or less functioning and many other serious things only. I think you have considered this report too in last consultation. His BUN is high , AST ALT ratio is high so creating lot of confusion.
2. In his CBC MCV MCH etc are low, i used to have same findings so i could find. In my smear it was always microcytic anemia opinion which is due to thalessemia. Ayansh CBC is having low MCV MCH too but how come his smear opinion is normochromatic and normocytic ? His IRON studies are also included and that is normal and uploaded too , please find that too. How serious is this and why its in normochromatic range , if MCV is low. Because normochromatic is associated with malignancies , chronic feature please give detailed answer, because it has worried me again.
3. Sorry again for AST ALT ratio, I read that for child till 3 years AST range is till 60 and considered normal (doctors knows better) and ALT range is till 45. If this is true then can a child can have higher AST and low ALT in general. Does AST ALT ratio matter in child up to 03 years? In earlier opinion you said that Lal path lab was wrong in mentioning chronic cirrhosis as opinion as its not valid for child but ratio more than 2 associated with other serious issues like liver neoplasia , failure etc.
4. His yellowness is relative kind of thing, when we see him alone he looks normal but when we compared with others he looks yellow, not yellow as it was shown in pics because camera produced color saturated images, I will upload a current pic with different camera. So when I see him alone he looks alright may be a litttle yellow non noticeable to all.
5. With child range is Urea value are almost kind of double. Is this can be dehydration means we try to keep him hydrated although he resists. How much water should be given. His urine frequency is normal. We give him lentils in night daily so far, and early morning is daliya with little lentils . In day lunch daliya is repeated to avoid constipation and give him hard fibers because when we were giving him iron supplements or ocassionally he was constipated. Meantime fruits , and milk.
With this normhochromatic thing whats your opinion as again its associated with lots of dreaded things. Kindly reply for all points . Thanks and Regards.
Hi Doctor
I have few queries again regarding last follow up, First thing is my son age is 2.2 not exact 02 years so will it change previous opinion?
1. I just noticed that in blood smear report of my son, normhocytic normhochromc anemia is mentioned as opinion. This anemia is associated with multiple chronic dreaded diseased, cancers chronic , renel failure or less functioning and many other serious things only. I think you have considered this report too in last consultation. His BUN is high , AST ALT ratio is high so creating lot of confusion.
2. In his CBC MCV MCH etc are low, i used to have same findings so i could find. In my smear it was always microcytic anemia opinion which is due to thalessemia. Ayansh CBC is having low MCV MCH too but how come his smear opinion is normochromatic and normocytic ? His IRON studies are also included and that is normal and uploaded too , please find that too. How serious is this and why its in normochromatic range , if MCV is low. Because normochromatic is associated with malignancies , chronic feature please give detailed answer, because it has worried me again.
3. Sorry again for AST ALT ratio, I read that for child till 3 years AST range is till 60 and considered normal (doctors knows better) and ALT range is till 45. If this is true then can a child can have higher AST and low ALT in general. Does AST ALT ratio matter in child up to 03 years? In earlier opinion you said that Lal path lab was wrong in mentioning chronic cirrhosis as opinion as its not valid for child but ratio more than 2 associated with other serious issues like liver neoplasia , failure etc.
4. His yellowness is relative kind of thing, when we see him alone he looks normal but when we compared with others he looks yellow, not yellow as it was shown in pics because camera produced color saturated images, I will upload a current pic with different camera. So when I see him alone he looks alright may be a litttle yellow non noticeable to all.
5. With child range is Urea value are almost kind of double. Is this can be dehydration means we try to keep him hydrated although he resists. How much water should be given. His urine frequency is normal. We give him lentils in night daily so far, and early morning is daliya with little lentils . In day lunch daliya is repeated to avoid constipation and give him hard fibers because when we were giving him iron supplements or ocassionally he was constipated. Meantime fruits , and milk.
With this normhochromatic thing whats your opinion as again its associated with lots of dreaded things. Kindly reply for all points . Thanks and Regards.
I have few queries again regarding last follow up, First thing is my son age is 2.2 not exact 02 years so will it change previous opinion?
1. I just noticed that in blood smear report of my son, normhocytic normhochromc anemia is mentioned as opinion. This anemia is associated with multiple chronic dreaded diseased, cancers chronic , renel failure or less functioning and many other serious things only. I think you have considered this report too in last consultation. His BUN is high , AST ALT ratio is high so creating lot of confusion.
2. In his CBC MCV MCH etc are low, i used to have same findings so i could find. In my smear it was always microcytic anemia opinion which is due to thalessemia. Ayansh CBC is having low MCV MCH too but how come his smear opinion is normochromatic and normocytic ? His IRON studies are also included and that is normal and uploaded too , please find that too. How serious is this and why its in normochromatic range , if MCV is low. Because normochromatic is associated with malignancies , chronic feature please give detailed answer, because it has worried me again.
3. Sorry again for AST ALT ratio, I read that for child till 3 years AST range is till 60 and considered normal (doctors knows better) and ALT range is till 45. If this is true then can a child can have higher AST and low ALT in general. Does AST ALT ratio matter in child up to 03 years? In earlier opinion you said that Lal path lab was wrong in mentioning chronic cirrhosis as opinion as its not valid for child but ratio more than 2 associated with other serious issues like liver neoplasia , failure etc.
4. His yellowness is relative kind of thing, when we see him alone he looks normal but when we compared with others he looks yellow, not yellow as it was shown in pics because camera produced color saturated images, I will upload a current pic with different camera. So when I see him alone he looks alright may be a litttle yellow non noticeable to all.
5. With child range is Urea value are almost kind of double. Is this can be dehydration means we try to keep him hydrated although he resists. How much water should be given. His urine frequency is normal. We give him lentils in night daily so far, and early morning is daliya with little lentils . In day lunch daliya is repeated to avoid constipation and give him hard fibers because when we were giving him iron supplements or ocassionally he was constipated. Meantime fruits , and milk.
With this normhochromatic thing whats your opinion as again its associated with lots of dreaded things. Kindly reply for all points . Thanks and Regards.
Brief Answer:
In asymptomatic child this report is of no significance
Detailed Answer:
Hi
Welcome again
Here I would like to repeat that doctors don't only analyse the reports, but also correlate it clinically and it's not always good to chase the reports.
I agree with you that if CBC shows low MCV and MCH and in smear there should be microcytic hypochromic picture. Microcytic hypochromic anemia can be there in iron deficiency and thalassemia. As iron studies are normal low MCV and MCH here can be explained by thalassemia minor.
In smear the report shows normocytic normochromic and that is not matching with the CBC report.
I am not able to open new CBC,LFT and KFT reports. I request to upload that again as I want to re analyse the reports.
Still I won't get worried much about this report because otherwise child is not showing any symptoms suggestive of any chronic illlness and also all the investigations are almost normal.
You are right about values of AST and ALT also. In children values of AST is comparitively higher and this is because of growing phase. As mentioned earlier AST is non specific marker of liver dysfunction as it is found in other cells also. But here as both AST and ALT are within normal limits, the ratio is not bothering me at all.
Child should pass at least 4 times urine in 24 hours or if precisely saying, the total urine output in 24 hours should be more than 1 ml/kg/hour.
This indicates good hydration. Based on urinary frequency you can adjust the fluid intake.Ideally total daily fluid intake in this age should be 1200 ml/day(assuming weight of 14 kgs for this age).
Don't worry much. Please re upload the new reports.
Thanks and regards
In asymptomatic child this report is of no significance
Detailed Answer:
Hi
Welcome again
Here I would like to repeat that doctors don't only analyse the reports, but also correlate it clinically and it's not always good to chase the reports.
I agree with you that if CBC shows low MCV and MCH and in smear there should be microcytic hypochromic picture. Microcytic hypochromic anemia can be there in iron deficiency and thalassemia. As iron studies are normal low MCV and MCH here can be explained by thalassemia minor.
In smear the report shows normocytic normochromic and that is not matching with the CBC report.
I am not able to open new CBC,LFT and KFT reports. I request to upload that again as I want to re analyse the reports.
Still I won't get worried much about this report because otherwise child is not showing any symptoms suggestive of any chronic illlness and also all the investigations are almost normal.
You are right about values of AST and ALT also. In children values of AST is comparitively higher and this is because of growing phase. As mentioned earlier AST is non specific marker of liver dysfunction as it is found in other cells also. But here as both AST and ALT are within normal limits, the ratio is not bothering me at all.
Child should pass at least 4 times urine in 24 hours or if precisely saying, the total urine output in 24 hours should be more than 1 ml/kg/hour.
This indicates good hydration. Based on urinary frequency you can adjust the fluid intake.Ideally total daily fluid intake in this age should be 1200 ml/day(assuming weight of 14 kgs for this age).
Don't worry much. Please re upload the new reports.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
In asymptomatic child this report is of no significance
Detailed Answer:
Hi
Welcome again
Here I would like to repeat that doctors don't only analyse the reports, but also correlate it clinically and it's not always good to chase the reports.
I agree with you that if CBC shows low MCV and MCH and in smear there should be microcytic hypochromic picture. Microcytic hypochromic anemia can be there in iron deficiency and thalassemia. As iron studies are normal low MCV and MCH here can be explained by thalassemia minor.
In smear the report shows normocytic normochromic and that is not matching with the CBC report.
I am not able to open new CBC,LFT and KFT reports. I request to upload that again as I want to re analyse the reports.
Still I won't get worried much about this report because otherwise child is not showing any symptoms suggestive of any chronic illlness and also all the investigations are almost normal.
You are right about values of AST and ALT also. In children values of AST is comparitively higher and this is because of growing phase. As mentioned earlier AST is non specific marker of liver dysfunction as it is found in other cells also. But here as both AST and ALT are within normal limits, the ratio is not bothering me at all.
Child should pass at least 4 times urine in 24 hours or if precisely saying, the total urine output in 24 hours should be more than 1 ml/kg/hour.
This indicates good hydration. Based on urinary frequency you can adjust the fluid intake.Ideally total daily fluid intake in this age should be 1200 ml/day(assuming weight of 14 kgs for this age).
Don't worry much. Please re upload the new reports.
Thanks and regards
In asymptomatic child this report is of no significance
Detailed Answer:
Hi
Welcome again
Here I would like to repeat that doctors don't only analyse the reports, but also correlate it clinically and it's not always good to chase the reports.
I agree with you that if CBC shows low MCV and MCH and in smear there should be microcytic hypochromic picture. Microcytic hypochromic anemia can be there in iron deficiency and thalassemia. As iron studies are normal low MCV and MCH here can be explained by thalassemia minor.
In smear the report shows normocytic normochromic and that is not matching with the CBC report.
I am not able to open new CBC,LFT and KFT reports. I request to upload that again as I want to re analyse the reports.
Still I won't get worried much about this report because otherwise child is not showing any symptoms suggestive of any chronic illlness and also all the investigations are almost normal.
You are right about values of AST and ALT also. In children values of AST is comparitively higher and this is because of growing phase. As mentioned earlier AST is non specific marker of liver dysfunction as it is found in other cells also. But here as both AST and ALT are within normal limits, the ratio is not bothering me at all.
Child should pass at least 4 times urine in 24 hours or if precisely saying, the total urine output in 24 hours should be more than 1 ml/kg/hour.
This indicates good hydration. Based on urinary frequency you can adjust the fluid intake.Ideally total daily fluid intake in this age should be 1200 ml/day(assuming weight of 14 kgs for this age).
Don't worry much. Please re upload the new reports.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Prasad
Hi, Doctor I have uploaded his CBC LFT KFT, with blood smear again for your consideration. 1. His fluid intake is definitely not around 1200 ml, he drink less, and I also was apprehensive about high protein intake by giving dal in night daily, but only a bowl XXXXXXX We change lentils types daily although. But we thought that for hia growth protein is required. 2. His urine output is 4 or more and volume appears normal too. 3. I am relieved for AST ALT ratio and values after your opinion, because its very scary too, giving high ratio and no where its mentioned that for child it should not hold good but there are papers about ratio reversal in child But again Google is source of half information and thats why expert opinion is required. Thanks for your opinion. For child attaining 3 year age it may remain so? 4. I am carrying beta trait so I thought its more probable to have him same trait, and same smear report, which is more likely. His MCV value is around 60 too, so volume is less, thats why I got worried that how come RBC (high in value due to small size in report too) is normal size here. Any hemolysis kind of thing or smt else adding fresh blood smt. Sorry for over thinking. 5. One more thing, I also noticed some weird smell from his breath like fruity or aldehyde like something different for some time, which appears normal now but not very sure what type of smell. And few days around now did not find too. Thanks and Regards.
Hi, Doctor I have uploaded his CBC LFT KFT, with blood smear again for your consideration. 1. His fluid intake is definitely not around 1200 ml, he drink less, and I also was apprehensive about high protein intake by giving dal in night daily, but only a bowl XXXXXXX We change lentils types daily although. But we thought that for hia growth protein is required. 2. His urine output is 4 or more and volume appears normal too. 3. I am relieved for AST ALT ratio and values after your opinion, because its very scary too, giving high ratio and no where its mentioned that for child it should not hold good but there are papers about ratio reversal in child But again Google is source of half information and thats why expert opinion is required. Thanks for your opinion. For child attaining 3 year age it may remain so? 4. I am carrying beta trait so I thought its more probable to have him same trait, and same smear report, which is more likely. His MCV value is around 60 too, so volume is less, thats why I got worried that how come RBC (high in value due to small size in report too) is normal size here. Any hemolysis kind of thing or smt else adding fresh blood smt. Sorry for over thinking. 5. One more thing, I also noticed some weird smell from his breath like fruity or aldehyde like something different for some time, which appears normal now but not very sure what type of smell. And few days around now did not find too. Thanks and Regards.
Brief Answer:
No signs of hemolysis here
Detailed Answer:
Thanks for follow up once more
I am sorry but I could not be able to find the new reports.
I request you to reattach the reports or if possible better write down the total WBC, neutrophil, lymphocytes, platelet counts, MCV, MCH values, ALT,AST, S. Bilirubin, smear picture, Urea and creatinine values. Or else you can mail me the reports at YYYY@YYYY .
Although the urine output is normal and suggests adequate hydration,it would be better if you encourage him for more fluid intake.
100 gms of most of the lentils contain about 20-25 gm of protein and total protein requirement for this age is about 1gm/kg/day. Other food items in daily use also contain protein but little in amount. So I don't think that total intake of protein in your child exceeds the recommended daily allowance.
You can continue giving the lentils as this is a good source of protein and protein is needed for proper growth.
His electrophoresis report is suggestive of thal. minor only.
There is no evidence of hemolysis in report as in hemolysis the indirect bilirubin increases. Here it is normal.
I am sorry but for me its really difficult to explain the cause of smell.I can understand that you may be trying to correlate with liver disorder, as fruity smell is found in liver dysfunction. But I dont find any reason to correlate this smell to liver dysfunction as clinically he is asymptomatic.
I hope this helps in alleviating your anxiety to a certain extent.
Regards
No signs of hemolysis here
Detailed Answer:
Thanks for follow up once more
I am sorry but I could not be able to find the new reports.
I request you to reattach the reports or if possible better write down the total WBC, neutrophil, lymphocytes, platelet counts, MCV, MCH values, ALT,AST, S. Bilirubin, smear picture, Urea and creatinine values. Or else you can mail me the reports at YYYY@YYYY .
Although the urine output is normal and suggests adequate hydration,it would be better if you encourage him for more fluid intake.
100 gms of most of the lentils contain about 20-25 gm of protein and total protein requirement for this age is about 1gm/kg/day. Other food items in daily use also contain protein but little in amount. So I don't think that total intake of protein in your child exceeds the recommended daily allowance.
You can continue giving the lentils as this is a good source of protein and protein is needed for proper growth.
His electrophoresis report is suggestive of thal. minor only.
There is no evidence of hemolysis in report as in hemolysis the indirect bilirubin increases. Here it is normal.
I am sorry but for me its really difficult to explain the cause of smell.I can understand that you may be trying to correlate with liver disorder, as fruity smell is found in liver dysfunction. But I dont find any reason to correlate this smell to liver dysfunction as clinically he is asymptomatic.
I hope this helps in alleviating your anxiety to a certain extent.
Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
No signs of hemolysis here
Detailed Answer:
Thanks for follow up once more
I am sorry but I could not be able to find the new reports.
I request you to reattach the reports or if possible better write down the total WBC, neutrophil, lymphocytes, platelet counts, MCV, MCH values, ALT,AST, S. Bilirubin, smear picture, Urea and creatinine values. Or else you can mail me the reports at YYYY@YYYY .
Although the urine output is normal and suggests adequate hydration,it would be better if you encourage him for more fluid intake.
100 gms of most of the lentils contain about 20-25 gm of protein and total protein requirement for this age is about 1gm/kg/day. Other food items in daily use also contain protein but little in amount. So I don't think that total intake of protein in your child exceeds the recommended daily allowance.
You can continue giving the lentils as this is a good source of protein and protein is needed for proper growth.
His electrophoresis report is suggestive of thal. minor only.
There is no evidence of hemolysis in report as in hemolysis the indirect bilirubin increases. Here it is normal.
I am sorry but for me its really difficult to explain the cause of smell.I can understand that you may be trying to correlate with liver disorder, as fruity smell is found in liver dysfunction. But I dont find any reason to correlate this smell to liver dysfunction as clinically he is asymptomatic.
I hope this helps in alleviating your anxiety to a certain extent.
Regards
No signs of hemolysis here
Detailed Answer:
Thanks for follow up once more
I am sorry but I could not be able to find the new reports.
I request you to reattach the reports or if possible better write down the total WBC, neutrophil, lymphocytes, platelet counts, MCV, MCH values, ALT,AST, S. Bilirubin, smear picture, Urea and creatinine values. Or else you can mail me the reports at YYYY@YYYY .
Although the urine output is normal and suggests adequate hydration,it would be better if you encourage him for more fluid intake.
100 gms of most of the lentils contain about 20-25 gm of protein and total protein requirement for this age is about 1gm/kg/day. Other food items in daily use also contain protein but little in amount. So I don't think that total intake of protein in your child exceeds the recommended daily allowance.
You can continue giving the lentils as this is a good source of protein and protein is needed for proper growth.
His electrophoresis report is suggestive of thal. minor only.
There is no evidence of hemolysis in report as in hemolysis the indirect bilirubin increases. Here it is normal.
I am sorry but for me its really difficult to explain the cause of smell.I can understand that you may be trying to correlate with liver disorder, as fruity smell is found in liver dysfunction. But I dont find any reason to correlate this smell to liver dysfunction as clinically he is asymptomatic.
I hope this helps in alleviating your anxiety to a certain extent.
Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Doctor
thanks for reply, breath smell I mentioned because I want to tell you about all the observations I have observed , I just want that since physically its not possible to show him to you so online nothing should be left. I am uploading the images here and also forwarding to your mentioned email too. I have uploaded these images and docs in earlier consultation so I thought it would be available to you. Thanks for diet advice too, because of high BUN i was worried whether we are giving him excess protein so wanted your opinion.
Actually i was worried that although he is more likely to have microcytic anemia because I also have same trait so it seems more practical and his CBC also have low MCV in 60 range so obviously his volume of RBC should be less but as his smear report mention normochromatic and normocytic so I was confused that if size were normal to fit in normochromatic then why MCV is low. Therefore I was worried for hemolysis angle. I am uploading for your consideration and expert view. Thanks for providing detailed consultation.
Can with low MCV and trait RBC can be normal size and volume, because he is anemic I think because of trait , reason to have low Hb, otherwise normal size with normal Hb would not be issue. Sorry for speculations but tension makes me thing in all weird directions . Thanks for understanding.
Thanks and Regards
thanks for reply, breath smell I mentioned because I want to tell you about all the observations I have observed , I just want that since physically its not possible to show him to you so online nothing should be left. I am uploading the images here and also forwarding to your mentioned email too. I have uploaded these images and docs in earlier consultation so I thought it would be available to you. Thanks for diet advice too, because of high BUN i was worried whether we are giving him excess protein so wanted your opinion.
Actually i was worried that although he is more likely to have microcytic anemia because I also have same trait so it seems more practical and his CBC also have low MCV in 60 range so obviously his volume of RBC should be less but as his smear report mention normochromatic and normocytic so I was confused that if size were normal to fit in normochromatic then why MCV is low. Therefore I was worried for hemolysis angle. I am uploading for your consideration and expert view. Thanks for providing detailed consultation.
Can with low MCV and trait RBC can be normal size and volume, because he is anemic I think because of trait , reason to have low Hb, otherwise normal size with normal Hb would not be issue. Sorry for speculations but tension makes me thing in all weird directions . Thanks for understanding.
Thanks and Regards
Hi Doctor
thanks for reply, breath smell I mentioned because I want to tell you about all the observations I have observed , I just want that since physically its not possible to show him to you so online nothing should be left. I am uploading the images here and also forwarding to your mentioned email too. I have uploaded these images and docs in earlier consultation so I thought it would be available to you. Thanks for diet advice too, because of high BUN i was worried whether we are giving him excess protein so wanted your opinion.
Actually i was worried that although he is more likely to have microcytic anemia because I also have same trait so it seems more practical and his CBC also have low MCV in 60 range so obviously his volume of RBC should be less but as his smear report mention normochromatic and normocytic so I was confused that if size were normal to fit in normochromatic then why MCV is low. Therefore I was worried for hemolysis angle. I am uploading for your consideration and expert view. Thanks for providing detailed consultation.
Can with low MCV and trait RBC can be normal size and volume, because he is anemic I think because of trait , reason to have low Hb, otherwise normal size with normal Hb would not be issue. Sorry for speculations but tension makes me thing in all weird directions . Thanks for understanding.
Thanks and Regards
thanks for reply, breath smell I mentioned because I want to tell you about all the observations I have observed , I just want that since physically its not possible to show him to you so online nothing should be left. I am uploading the images here and also forwarding to your mentioned email too. I have uploaded these images and docs in earlier consultation so I thought it would be available to you. Thanks for diet advice too, because of high BUN i was worried whether we are giving him excess protein so wanted your opinion.
Actually i was worried that although he is more likely to have microcytic anemia because I also have same trait so it seems more practical and his CBC also have low MCV in 60 range so obviously his volume of RBC should be less but as his smear report mention normochromatic and normocytic so I was confused that if size were normal to fit in normochromatic then why MCV is low. Therefore I was worried for hemolysis angle. I am uploading for your consideration and expert view. Thanks for providing detailed consultation.
Can with low MCV and trait RBC can be normal size and volume, because he is anemic I think because of trait , reason to have low Hb, otherwise normal size with normal Hb would not be issue. Sorry for speculations but tension makes me thing in all weird directions . Thanks for understanding.
Thanks and Regards
Brief Answer:
Re analysed the reports, No need to worry
Detailed Answer:
Hi
Thanks again for believing in me
I have checked the reports once again and there is nothing to worry.
There is marked improvement in total leucocytes and neutrophil counts(compare to previous values). LFT is also within normal limit(Please don't follow the mentioned reference values of AST). Mild anemia and mildly low MCV/MCH is well explained and correlates with th. minor (Electrophoresis report). No need to worry about the smear report.
I can understand your concern, so don't say sorry and also don't get tensed.There should not be any doubt.
Please feel free to share any concern. I will try my best to clear all your doubts.
Best regards
With best regards
Re analysed the reports, No need to worry
Detailed Answer:
Hi
Thanks again for believing in me
I have checked the reports once again and there is nothing to worry.
There is marked improvement in total leucocytes and neutrophil counts(compare to previous values). LFT is also within normal limit(Please don't follow the mentioned reference values of AST). Mild anemia and mildly low MCV/MCH is well explained and correlates with th. minor (Electrophoresis report). No need to worry about the smear report.
I can understand your concern, so don't say sorry and also don't get tensed.There should not be any doubt.
Please feel free to share any concern. I will try my best to clear all your doubts.
Best regards
With best regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Re analysed the reports, No need to worry
Detailed Answer:
Hi
Thanks again for believing in me
I have checked the reports once again and there is nothing to worry.
There is marked improvement in total leucocytes and neutrophil counts(compare to previous values). LFT is also within normal limit(Please don't follow the mentioned reference values of AST). Mild anemia and mildly low MCV/MCH is well explained and correlates with th. minor (Electrophoresis report). No need to worry about the smear report.
I can understand your concern, so don't say sorry and also don't get tensed.There should not be any doubt.
Please feel free to share any concern. I will try my best to clear all your doubts.
Best regards
With best regards
Re analysed the reports, No need to worry
Detailed Answer:
Hi
Thanks again for believing in me
I have checked the reports once again and there is nothing to worry.
There is marked improvement in total leucocytes and neutrophil counts(compare to previous values). LFT is also within normal limit(Please don't follow the mentioned reference values of AST). Mild anemia and mildly low MCV/MCH is well explained and correlates with th. minor (Electrophoresis report). No need to worry about the smear report.
I can understand your concern, so don't say sorry and also don't get tensed.There should not be any doubt.
Please feel free to share any concern. I will try my best to clear all your doubts.
Best regards
With best regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor So do I need to repeat test further after some time for observation of AST values, or BUN values, because BUN value is high presently. Or can I feel safe and not to worry for that. He is growing teeth too, and today has light fever ( he doesn't put on any bedsheet or anything in night at all), so are such symptoms like fever to be taken seriously, or which symptoms you think are to be taken seriously or for observation. Means if this incident hadn't happened of Lal path labs so our approach would be totally different, and taking it lightly, but reports made case difficult. Although as you have said reports are normal, I am relaxed about report but Are these reports that normal that I wouldn't worry in future for such light feverish temperature like incidents. Thanks for consultations, and time. Thanks and Regards
Hi Doctor So do I need to repeat test further after some time for observation of AST values, or BUN values, because BUN value is high presently. Or can I feel safe and not to worry for that. He is growing teeth too, and today has light fever ( he doesn't put on any bedsheet or anything in night at all), so are such symptoms like fever to be taken seriously, or which symptoms you think are to be taken seriously or for observation. Means if this incident hadn't happened of Lal path labs so our approach would be totally different, and taking it lightly, but reports made case difficult. Although as you have said reports are normal, I am relaxed about report but Are these reports that normal that I wouldn't worry in future for such light feverish temperature like incidents. Thanks for consultations, and time. Thanks and Regards
Brief Answer:
Please don't relate this fever with previous reports
Detailed Answer:
Hi
I can understand your concern. Being a caring and educated parent, its quite genuine to get disturbed because of variation in opinion or reports. But I would like to repeat again that I wont get worried for reports as there is nothing much to worry.
Unnecessary investigations can create lot of confusion because difference in calibration and reference range from different labs. A physician will not worry unless the reports are really deranged significantly and that too correlates well with clinical symptoms.
Its upto you,but personally I don't think that any repeat test for urea or AST is needed.
I don't find any reason to correlate recent fever with old reports. If previous reports are normal,that too does not suggest that child will be alright in future. I mean any new infection/illness can occur and if needed we have to get few tests done depending on symptoms.
Regarding recent episode of fever I would suggest you to observe him closely. Please measure the temperature by thermometer, if you feel that he is warm.This will help in proper assessment of fever.
If fever is high(more than 100 F),please give 7.5 ml of paracetamol suspension( 120 mg/5 ml formula).
In case if you notice any other significant complaints, please visit your nearest pediatrician. You can also write me back.
I hope this helps.
Wishing for good health of your baby.
Regards
Please don't relate this fever with previous reports
Detailed Answer:
Hi
I can understand your concern. Being a caring and educated parent, its quite genuine to get disturbed because of variation in opinion or reports. But I would like to repeat again that I wont get worried for reports as there is nothing much to worry.
Unnecessary investigations can create lot of confusion because difference in calibration and reference range from different labs. A physician will not worry unless the reports are really deranged significantly and that too correlates well with clinical symptoms.
Its upto you,but personally I don't think that any repeat test for urea or AST is needed.
I don't find any reason to correlate recent fever with old reports. If previous reports are normal,that too does not suggest that child will be alright in future. I mean any new infection/illness can occur and if needed we have to get few tests done depending on symptoms.
Regarding recent episode of fever I would suggest you to observe him closely. Please measure the temperature by thermometer, if you feel that he is warm.This will help in proper assessment of fever.
If fever is high(more than 100 F),please give 7.5 ml of paracetamol suspension( 120 mg/5 ml formula).
In case if you notice any other significant complaints, please visit your nearest pediatrician. You can also write me back.
I hope this helps.
Wishing for good health of your baby.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Please don't relate this fever with previous reports
Detailed Answer:
Hi
I can understand your concern. Being a caring and educated parent, its quite genuine to get disturbed because of variation in opinion or reports. But I would like to repeat again that I wont get worried for reports as there is nothing much to worry.
Unnecessary investigations can create lot of confusion because difference in calibration and reference range from different labs. A physician will not worry unless the reports are really deranged significantly and that too correlates well with clinical symptoms.
Its upto you,but personally I don't think that any repeat test for urea or AST is needed.
I don't find any reason to correlate recent fever with old reports. If previous reports are normal,that too does not suggest that child will be alright in future. I mean any new infection/illness can occur and if needed we have to get few tests done depending on symptoms.
Regarding recent episode of fever I would suggest you to observe him closely. Please measure the temperature by thermometer, if you feel that he is warm.This will help in proper assessment of fever.
If fever is high(more than 100 F),please give 7.5 ml of paracetamol suspension( 120 mg/5 ml formula).
In case if you notice any other significant complaints, please visit your nearest pediatrician. You can also write me back.
I hope this helps.
Wishing for good health of your baby.
Regards
Please don't relate this fever with previous reports
Detailed Answer:
Hi
I can understand your concern. Being a caring and educated parent, its quite genuine to get disturbed because of variation in opinion or reports. But I would like to repeat again that I wont get worried for reports as there is nothing much to worry.
Unnecessary investigations can create lot of confusion because difference in calibration and reference range from different labs. A physician will not worry unless the reports are really deranged significantly and that too correlates well with clinical symptoms.
Its upto you,but personally I don't think that any repeat test for urea or AST is needed.
I don't find any reason to correlate recent fever with old reports. If previous reports are normal,that too does not suggest that child will be alright in future. I mean any new infection/illness can occur and if needed we have to get few tests done depending on symptoms.
Regarding recent episode of fever I would suggest you to observe him closely. Please measure the temperature by thermometer, if you feel that he is warm.This will help in proper assessment of fever.
If fever is high(more than 100 F),please give 7.5 ml of paracetamol suspension( 120 mg/5 ml formula).
In case if you notice any other significant complaints, please visit your nearest pediatrician. You can also write me back.
I hope this helps.
Wishing for good health of your baby.
Regards
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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