[lola1973]

My ds daughter is fourteen and has hypothyroidism controlled with meds and has had three open hearts 1995, 2000, and 2007. I had a routine cbc run on her and I am concerned about a few things. Here it goes
Wbc was 5.7 bil and range was 4.5-13.0
Rbc was 4.26 tril and range was 3.73-5.30
Hgb was 14 and range was 11.7-15.6
Hct was 39.9% range was 34.6-45.5
Mcv was 93.7 range was 80-96
Mch was 32.9 range was 27-33
Mchc was 35.1% range was 33-35 this was out of range on high side
Rdw-sd was 44 range was 40-50
Rdw-cv was 13% range was 11-14
Plt was 206 range was 150-450
Neut was 2.8 range was 1.8-8.0
Lymph was 1.8 range was 1.2-5.2 is this too low?
Mono was 0.7 range was 0.2-0.7 should I be concerned this is high end of normal?
Eos was 0.4 range was 0.1-0.4 should I be concerned that this is high end of normal?
Baso was 0.1 range was 0.0-0.1
I'm gran was 0.01 range was 0.00-0.03
I know some might wonder why I am concerned, she is down syndrome and has controlled hypothyroidism. I am concerned because she has had three open heart surgeries 1995,2000,and 2008. I am worried she could have gotten a blood borne illness from the transfusions. The cardio has assured me that the option of that is nil and I need to stop worrying. I was just hoping someone would look atv this and say we see labs like this all the time and it is just fine. j-9, since you have answered stuff in the past and have made me feel better I so trust you and hope you could take a few minutes to ponder these labs and give me your honest opinion.thank you so much

[J_9]

mchc was 35.1% range was 33-35 this was out of range on high side

It's only 0.1% on the high side, so I wouldn't be too concerned unless this happens routinely.

lymph was 1.8 range was 1.2-5.2 is this too low?

Still within the normal range right? ;)

mono was 0.7 range was 0.2-0.7 should i be concerned this is high end of normal?
eos was 0.4 range was 0.1-0.4 should i be concerned that this is high end of normal?

Again, these are both within the normal range aren't they? High end of normal - low end of normal, either way it's still normal.

i am worried she could have gotten a blood borne illness from the transfusions.

What blood borne illness are you worried about HIV/AIDS? Hepatitis?

You would need to have liver panels checked for Hepatitis.

Otherwise, everything is within the normal range. Since I don't know your daughter, am not her doctor/nurse, and have not reviewed her medical records, I would say that you need to believe in what your health care provider is telling you. If you are still concerned, seek another opinion.

[lola1973]

thanks J-9,
for some reasoni got worked up about this bloodwork. She is the light of my life and I would never want anything to happen to her. Her pediatrician and cardio have both seen the bloodwork and nothing set off alarms for them. I will show ger endo. When we go in Monday. My concern was hiv from the blood transfusion in 2007, her cardiologist basically said no way! I truly have put all my trust in him for 13 years and he is the best of the best,my dad was best friends with the top dog at a children's hospital and found this guy for us. The eos, lymph, mono, and wbc counts scared me. I guess I wish they were more average. I know realistically I have gotten myself worked up for nothing, I just wondered if you had seen lab values like this before in healthy patients. Sorry I am such a worried mom.

[J_9]

I work in Labor and Delivery primarily, but in my clinical days I have seen labwork like this and there was no need to worry because they are still within normal range.

Since the late 1980s, I believe, all blood has been tested for HIV/AIDS prior to transfusion into a patient.

Did your daughter have a cold or flu prior to this labwork? Change in meds possibly?

I really see no reason to worry.

[lola1973]

she was diagnosed with asthma two days prior, which could have been a viral bronchitis to start with. She does have hypothyroidism and we go to the endo on Monday so for all I know her tsh is off too. I had talked to a Dr. that said there was no way in you know what that you could get hiv through a blood transfusion these days. I am also assuming that two doctors who know her history have looked at this and it didn't alarm them, so I have to let it go. So basically they coulf pull blood on any fourteen year old girl who is perfectly healthy and get these results? The more I think about it I have to think about what a friend said to me regarding the labs, if it was hiv some things would be way off including her platelets and hemoglobin. Also, like she said if the labs were off it could mean other things too. Is that kind of your opinion that these are normal values and reading into them is a dumb thing to do because they are typical values? Thanks again, and your kind words have really helped me.

[J_9]

As I stated before, these are normal labs and there is nothing you should be worried about. If it were HIV you would have a very abnormal white blood cell count (WBC). Since her WBC is within the normal range, I would have to rule out HIV at this stage. If you are that concerned you should ask for an ELISA test, but I doubt they would do it with labs that look as good as this.

HIV from transfusions has been greatly reduced, if not eradicated, since the late 1980s.

[lola1973]

Hi j-9. just wanted to show the info I got back from a lab my friend works for.she gave them the labs to review. I feel much better after what they said and what you said, so I know now know there is no fear.thank you for helping me. It was funny because some people I asked said that cbc won't tell you anyhting, but as soon as I got somereal professional they said if she had her surgery 18 months ago and got anything something funny would be showing up, do you agree with that? Here is the info I got.

"actually, your daughter''s cbc looks just fine. the mchc is just a measure of the amount of hemoglobin in an individual red blood cell. your daughter''s is so close to the range so as not to be of concern. also, we usually only consider these numbers if the person is anemic, which your daughter is not. your daughter''s white count is also good. the lymphs, monos and eos are individual types of red blood cells - they are perfectly fine too. the white blood cells can fluctuate quite a bit. so you have nothing to worry about with the cbc."

Another dr wrote this to me,he specializes in hiv, he had givesn me much info and this is just one sentence from our conversation:

"As I said above, there is no risk these days for HIV from blood transfusions"

Again, I don't know why I got so fixated on this. I have never worried about it before and I know realistically that there is no reason to worry. Now that I have had three medical people review it I can sleep better. Her cardio had actually looked at me strangely when I mentioned being concerned about blood transfusions. He said no need to worry. I also know many women who have had them after csections. Thanks again for everything. You seem very knowledgeable and considerate and I am sure your patients love you. Have a great holiday season!

[lola1973]

Also, I think the real reason I got concerned was last week on one place on her forearm she had petechia in one area. The dr. pulled a qbc and everything was fine with her platelets. The dr. said it could be from laying on her arm at night when she is sleeping, or form hitting her arm on something. It want away and the dr said that is also a good sign, because if it was anything it would last. So I guess that is what got my mind spinning! I am such a momma bear when it comes to her, she is the light of my life.

[J_9]

I'm glad you are feeling better about this. I'm sure it was good to hear basically the same thing from 3 different outside sources.

Your daughter is very luck to have a mother as caring as you.

You have a happy holiday season yourself.

[lola1973]

Thanks again. I do feel much better. She has to get her blood pressure taken all the time and they use the automated machine which inturn woyuld squeeze so hard it woyuld leave petechia in a few small areas under the blood opressure cuff. My Dr. is ultra conservative and said it was probably fine because ot is like a tourniquet and can cause petechia. He drew blood anyway and that is what made me nervous. Since then I have talked to a few of my friends who said they get petechia on their arms where the blood pressure cuff is or if the tourniquest was too tight for a blood draw. I wish I had that info before all of this.

[J_9]

I get petechia all the time when my blood pressure is taken. It's just because the tiny capillaries break open with the pressure of the cuff, no big deal. I get it all over my lower legs after a 12 hour shift at the hospital. As long as they go away within a few hours it's nothing to concern yourself over.

[lola1973]

You are fantastic!! Thanks for making me feels tons better. I can now enjoy the tons of family I have coming over for Thanksgiving. She had her blood pressure taken yesterday and this morning and they have not completely disappeared yet, but as long as they disappear in the next few days and don't get bigger than that is what is causing it , the blood pressure cuff?she is very fare skinned and has sensitive skin. Also, this has nothing to do with anything, but it really put things in perspective for me today. A friend who was battling colon cancer for three years passed away today.she has two sons, 7 and 3. it made me realize I can't live my life worrying about everything,I just have to live each day to the fullest.

[lola1973]

Ok latest bloodwork and platelets were good. Question for you, her eosonphils and monocyte % were high, but her absolute counts on moncytes and eosonphils were in range. Is the absolute a better thing to look at? Also, her lymph% was right at the bottom 25% but when I multiply it by her wbc to get the absoulte count it is well with in range.