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Why does my son have persistently high WBC counts?

Answered by
Dr.
Dr. Kiran Kumar

Internal Medicine Specialist

Practicing since :2007

Answered : 362 Questions

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Posted on Sun, 6 May 2012 in Infections
Question: Hi doctor,

My son is presently 1.2yrs old.actually we adopted him from a renowned agency when he was 2.5months old.
but from his birth till date his wbc counts are high.

at 15 days old -----0000,hb-16.5
at 2 months ----0000
at 2.5months -----0000
at 3 months -----19,550,hb-10.4,platelet-0000(RBCS MORPHOLOGY-Normocytic normochromic
WBCS MORPHOLOGY-mildly increased for age with normal distributions,
few transformed lymphocytes are seen,no atypical lymphocytes seen)
at 6 months -----16,700
at 7 months -----13,340(this count was taken 10 days after antibiotics treatment given for cold)

at 1.2yrs(present)--18,381,hb-12.2,platelates-0000 (RBCS MORPHOLOGY-Normocytic normochromic,microcytes
WBCS MORPHOLOGY-Band form+,toxic granules+)

He was born full term with birth weight of 2.94kgs.

His TSH was 2.52(negative) done on 5th day after birth.

He got jaundice at 48hrs from birth and his billirubin total on 2nd day was-11.6mg/dl and direct was-0.46mg/dl.but after 1

week no symptoms mentioned.

Untill 3 months he had phimosis, but later it got resolved.

He also has a small umbillical Hernia, doctor told mostly it will go away by he turns 3 yrs.( No redness or swollen).

He had a small patent foramen ovale which got closed, shown in echo recently

his ultasound of abdomen and pelvis shows no significant abnormalities done recently.

He was tested for hiv,hbsg and vdrl when he was 2months old and all were NEGATIVE.

Urine and stool tests done many times before all fine .

we are really worried as his wbc counts are persistently high.but he is otherwise quite active child,no fever or lethergy or

any other symptoms.we consulted good padeatrician and he told our baby seems to be perfectly fine and he couldnot pinpoint

the underlying problem till date.Today again we have given his urine and stool for testing as on doctor's advice results are

awaited.

My questions to you are-

1)Why is he having persistently high WBC counts?

2)Could you please suggest us how we should go about finding the cause of the underlying problems behind high wbc counts as

we are really very worried.Also,could you please mention the respective tests needed to be done other than haemogram,stool

and urine analysis to rule out any major problems.(echo and abdominal scan already done).

3)Is their any possibilities of him having any blood related disorders or leukemia or any other childhood cancers with such

counts?

We are extremely tensed and nervous,kindly help us in the diagonisis.

Thanks XXXXXXX



doctor
Answered by Dr. Kiran Kumar 8 hours later
Hi XXXXXXX

Thanks for posting your query.

Your child has elevated WBC counts since child hood and all evaluation has been normal till now. Also your child is active and has no signs of infection.

Now coming to your questions.
1 & 2. WBC counts can be elevated due to following reasons.

An increased production of white blood cells to fight an infection
A reaction to a drug that enhances white blood cell production
A disease of bone marrow, causing abnormally high production of white blood cells such as leukaemia
An immune system disorder that increases white blood cell production

Your child WBC counts are around 20 - 25 thousands. The peripheral smear suggests Band Forms with Toxic Granules. Such features are a response to systemic infection.

You wll have to get your child evaluated with respect to systemic infection

Following Test will be helpful to identy any infection (If present)
Blood Cultures - bacterial and Fungal
Urine Cultures
CT Scan of the Abdomen and Chest
Stool for Culture
Stool for Clostridium Difficle

3. Leukaemia is unlikely to go missed as your have blood counts so often.
So you can discuss with the paediatrician regarding any further examinations or tests. Go for Bone Marrow Examination as this will clearly show the type of cells morphology.

If no cause is ascertained, then, your might have to wait and watch as your child is active and healthy.

Hope this answers your query.
Please get back if you need any further information.

Thanks and Regards

Dr Kiran
Above answer was peer-reviewed by : Dr. Radhika
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