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What Causes Low Wbc Count,high Lymphocytes And Enlarged Lymph Nodes?

Posted on Thu, 5 Jun 2014

Question: Hi my daughter 5 years old. She have abdominal pain for a few seconds at a time but several times a day happen around beginning april and many many flatulence or gassy. not until 2 weeks later i try to find out why because there are no other symptoms like diarrhea or headache or vomit. she is still healthy and eating well and also very active so i thought its just from eating dirty or will pass somehow. I gave her YAKULT drink. then after 2 weeks takes her to ultrasound that show enlarge lymph nodes. so taking blood test in singapore show low blood counts 2 weeks ago showing result of 4.7 (reference 6 - 17) with neutrophil 42 (normal 28-57) and lymphocytes 51 (normal 36 - 72) and 3 days ago test done in indonesia and turns out the white blood count is a bit lower than before which is 3.8 (reference 5.5 - 14.5) but today results comes out with lymphosite higher than normal which is 55.9 (normal 25-50) then neutrophil lower then normal which is 36.8 (normal 50-70). she have been to 2 gastroenterologist and 3 paeditrician and the pain still there. its been 1 month already and i am very worried. She test her urine and stool as well all turns out good. no bacteria found and also test for helicobacter and also turns out negative. so far the probiotic called LACTEOL FORT seems to make her feel better although the pain is still there.

FIRST DOCTOR DRUG GIVEN - 16 APRIL - 18 APRIL - GETTING WORSE ABDOMINAL PAIN
GASFAMIN TAB 20, STROCAIN P 400 MG, PRONICY 4

SECOND DOCTOR DRUG GIVEN - 18 APRIL - 22 APRIL - GETTING BETTER BUT PAIN STILL THERE
BRAXIDIN, OMEPRAZOLE 20MG, PROPEPSA SUCRALFATE

THIRD DOCTOR DRUG GIVEN - 23 april - 26 april - getting diarrhea with a weird white mucus looks like fats but under water all around the faeces. DIARRHEA ONLY FOR 24 HOURS.
DEBRIDAT, LOSEC MUPS, SUCRALFATE

FOURTH DOCTOR JUST GIVE ME LACTEOL FORT SINCE 27 APRIL UNTIL NOW. THE FIRST WEEK AFTER EATING THIS LACTEOL FORT SHE IS SOMETIMES HAVING PAIN AND SOMETIMES NOT AT ALL IN ONE DAY. THEN STARTING THIS WEEK, SHE IS HAVING A FEW MORE PAIN BUT MAYBE BECAUSE SHE HAVE BEEN EATING A FEW MORE FOOD WHICH IS NOT SOFT ...

i realize that she said she have this a bit tingling and sometimes pain she said in her vagina area a few times this week, however the urine cultur and urinalisis turns out nothing.

she also have specific pain in belly button. not anywhere else.

Answered by Dr. Uma Rajah Ananth (41 hours later)

Brief Answer:
may be food allergy or viral infction.

Detailed Answer:
Hi XXXXXXX

The Low wbc count, relatively high lymphocytes, ultrasound showing enlarged lymph nodes are all suggestivc of a possible viral infection.

If it is so it should improve with time.

Hope renal functions and liver functions in blood are OK and have been checked.

I would also suggest you stop the so called fresh milk available in cartons, also flavoured milk and yoghurts.

Because food allergy including preservatives,food flavours etc can cause such problem.

So consider this and be careful with the diet.

If probiotics do not help you can stop them.

Good luck

God bless

Dr Uma

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

Follow up: Dr. Uma Rajah Ananth (2 days later)

yes the WBC have improve. however her tummy pain is still there everyday. yesterday just check her stool and came out positive with leucocytes 0-1. what is it means? and also written positive of fiber. i will upload new attachment. please help .. its been 1.5 month she have this pain ..

Answered by Dr. Uma Rajah Ananth (3 hours later)

Brief Answer:
do not worry

Detailed Answer:
Hi XXXXXXX

Do not worry!

Stool result is normal ( 1-2 wbcs and fibres are normal)

Liver function tests are absolutely normal.

She has been extensively investigated.

This is only some strange virus.

It will take some more time.

Counts are improving.

Do no it expose her to crowded places,malls etc for another 2-3 weeks.

Give bland home made diet without preservatives.

Use boiled cooled water for drinking.

Avoid fish,meat for some more time.

Use milk like nido powder reconstituted.

She should improve soon.

God bless
Dr uma

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

Follow up: Dr. Uma Rajah Ananth (44 minutes later)

Thank you so much Dr. Uma. She have been having this pain for 1.5 months. And today for the first time she have fever 37.3 - 37.8. Is it normal too? Why now fever comes? i am confused, i thought it should be near over but then suddenly this fever came. I can't stand that i cry a lot today. I really begging for answer. what is this virus. I really hope she is getting well tommorow. please advise me. and thank you so very much for giving time to answer me so quick. thanks

Answered by Dr. Uma Rajah Ananth (2 hours later)

Brief Answer:
she will improve

Detailed Answer:
Dear XXXXXXX

Fever may be unrelated to the illness.

You are in Singapore/ Indonesia which are near the equator and very prone to viral infections with wet and hot weather.

Kids do get fevers ,viral infections very easily especially if they go to day care or play school!

I know it is hard to see a child suffering, but still you have to b thankful that it is not a serious illness.

So don't cry,be brave and support her.

You should,d wait and watch this fever.

If it does not subside in 2-3 days,go to the pediatrician there for examination.

God bless

Dr Uma

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

Follow up: Dr. Uma Rajah Ananth (5 hours later)

alright Dr. UMA. Our family doctor actually found strange that after eating she always start having pain and passing gas wind. before the pain takes only a few seconds no more than 8 seconds. nowadays the pain is getting longer with a minimum 30 seconds to 2 minutes. and pain also start coming in the middle of the night. last night she is awake for 4 times and ask for passing stool but she isn't able to do it so she go back to sleep. Our doctor told us maybe its time to give her an endoscopy because it seems to get longer pain and more troubling her in a day compare to before when she is not bothered with it. what do you think?

Answered by Dr. Uma Rajah Ananth (14 hours later)

Brief Answer:
yes

Detailed Answer:
Yes XXXXXXX

if the Pain is worsening, endoscopy can be done.

It will rule out gastritis,etc.

H pylori can be tested.

Have they ruled out stones!? I would also do that as the nature of pain and site of pain.

Good luck

Dr uma

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

Follow up: Dr. Uma Rajah Ananth (2 hours later)

Thank u so much Doctor Uma. We are planning to go singapore and do the endoscopy there next week. Tommorow we are having an ultrasound for her stomàch. Then the result of a new stool test also will be available. Because starting today she is starting to have a fluffy stool. Thanks a lot for your help. Any more other suggestion you could give me will be greatly appreciated. Please feel free to contact me if u plan to come to indonesia and I will be happy to guide and help u with anything as my thanks. Sorry to bother again .. can you please explain what is colitis and ileitis? my doctor thinks he will look endoscope for this disease. why any body could get this colitis and ileitis? this is for me to learn so i know in the future what to do or don't and what to eat and don't eat. i just hope u can help me explain .

Answered by Dr. Uma Rajah Ananth (8 hours later)

Brief Answer:
please wait or diagnosis

Detailed Answer:
Hi XXXXXXX

Thanks.

I wish and pray for your daughter's,speedy recovery

Colitis is any pathology in large bowel or large intestine and ileitis is some pathology in small intestine called ileum.

This' means they are planning colonscopy.

Yes it is better to repeat ultrasound also.

There are many conditions which cause abdominal pain - so wait till a diagnosis is arrived before we decide about the future course

God bless

Dr Uma

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

Follow up: Dr. Uma Rajah Ananth (14 hours later)

Hi Dr. Uma. Just done ultrasound and found out thickening of ileum area hypoechoic. Then paeditrician now ask me to do CT Scan instead of colonoscopy. And i just wonder, is it better for children to have MRI instead of CT Scan considering that CT scan will have some radiation??

Answered by Dr. Uma Rajah Ananth (23 hours later)

Brief Answer:
yes

Detailed Answer:
Yes XXXXXXX

Each one has its own merit, t how some pathology better .

So leave it to the doctor.

Of course it is true that CT gives more radiation.

Dr uma

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