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Forum Name: Pediatric Topics

Question: Frequent infection, persistent hives, possible leukemia?


 ltf500 - Mon Dec 29, 2008 2:35 pm

My 21 month old son has been having frequent infections for the past 6 months - low grade fever, colds, ear infections, pink eye. He developed a case of widespread hives 6 weeks ago that is unremitting. He has had excema since birth and several severe diaper rashes and abcesses that grew bacteria. We have ruled out food allergy as a cause of the hives and haven't introduced any new foods, detergents, etc.

Dr. ran blood tests and they came back showing low neutrophils, high lymphocytes, relatively low HCT and an elevated sed rate. Dr. did not seem concerned about leukemia (which I know is reassuring), but I continue to worry since he has had one infection after another and the hives persist.

Your advice would be greatly appreciated.
 Tom Plamondon PA-C - Tue Feb 24, 2009 7:41 pm

User avatar Hello,
Thanks for writing in. Sorry about the delay.

With lymphocytosis (elevated lymphocyte count), recurrent infections, a drop in red cell and neutrophil count, the idea of leukemia naturally would cross the mind.

One simple way of judging if the lymphocytosis is reactive (e.g. from viral infection) or malignant is to recheck the CBC after illness subsides to see if the cell count normalizes. Any abnormalities during non illness may warrant further testing.

I'll run this past the oncology department too to get their opinion.

All the best to you.
 Dr yasmin taha MD - Wed Feb 25, 2009 3:18 am

Dear Tom,
The guest has not mentioned any specific information that I can use to give an opinion.
But ill try to help: lymphocytes are normally increased and could be physiological,
low WBCs are responsible for recurrent infection, while anemia may have several causes other than leukemia.
So a complete CBC including morphology of blood cell can make the diagnosis clearer and suggest other investigations if needed.

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