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- Thu Nov 09, 2006 6:40 pm
My 3yr old has had a total of 3 complete blood workups. 1st one had normal platelet count at birth of 243 thous/ 2nd test at age 1.5 year showing increased platelet count of 465 thous/ with elevated eosinophil count then 3rd test at 3yr check up showing even more increased platelet count of 565 thous/ with continued elevated eosinophils. Is the gradual continuos increase in platelets and eosinophils a concern. The doctor wants to wait until they reach 900 thous before further testing. the normal range on the lab for his age is 150-400.
| Dr. Tamer Fouad
- Thu Nov 30, 2006 12:15 pm
I am not a pediatrician however, I can tell you that platelets respond like an acute-phase reactant to tissue injury and many acute infections.
Hence, thrombocytosis can result from acute infections; inflammatory/immune diseases (rheumatoid arthritis); mechanical causes/trauma (burns, postsplenectomy); metabolic/toxic causes (exercise, cirrhosis, iron deficiency).
On the other hand, it can also be caused by neoplastic and myeloproliferative diseases (polycythemia vera, essential thrombocythemia, myelocytic leukemia) or vascular hemorrhage.
Eosinophilia may be primary or secondary to an underlying disorder. Allergic or atopic diseases are the most common causes, with respiratory and skin diseases most prominent. Eosinophilic drug reactions which are usually asymptomatic, may be associated with interstitial nephritis, serum sickness, cholestatic jaundice, hypersensitivity vasculitis, and immunoblastic lymphadenopathy.
Almost any parasitic infection can elicit eosinophilia, but not protozoa and noninvasive metazoa.
Nonparasitic infections also may be accompanied by eosinophilia. Hodgkin's disease may cause marked eosinophilia, whereas non-Hodgkin's lymphoma, acute lymphoblastic leukemia and chronic myelogenous leukemia are less often accompanied by eosinophilia. Ovarian cancer is the leading solid tumor associated with eosinophilia. Connective tissue disorders with increased circulating immune complexes and vasculitis are often associated with eosinophilia.
Your doctor is correct to wait and observe your child's blood count. If any other abnormality should arise or he should complain of any new symptoms you should report to his doctor as soon as possible.
Otherwise, the investigations done for these disorders is often invasive and traumatic to the child (such as a bone marrow biopsy) and should be reserved for those that are at high risk of disease.