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High platelet count/CML question
I've got a small four year old. He weighs 28 pounds. Two years ago he
weighed 26.5 pounds. My doctor is very worried about this. He asked for a CBC count. It came back with lowish iron: 11.3, normal white blood: 6.5 and high platelet count, 514 where 150-400 is normal. I'm trying to put this in context and figure out what next to do with him. I'd appreciate any perspective or insight. This has us all puzzled. The child acts well, eats normally (sometimes he has an appetite, sometimes he doesn't) and has normal energy levels. He doesn't get sick easily (and hasn't had a cold yet this fall.) He has no trouble keeping up with his active preschool class. He doesn't need naps. But he's got two bizarre health problems: a year ago he nearly died from a perforated intestine and the resulting peritonitis and we have never figured out what caused the perforations (there were several small ones in his upper intestine.) At that time he had an ileus for about two weeks and lost quite a lot of weight - he has regained it all and doesn't appear to be skeletal, he's just SMALL. The other bizarre health problem is his teeth are shot. Just before he turned four he suddenly presented with five cavities and an abscessed tooth. We were never lax about his everyday dental care but in the past four months (since this problem suddenly developed) we've been totally anal about brushing and flossing and fluoride. And yet new cavities are still showing up and now he's up to SEVEN cavities with two abscesses. (Well, one abscessed tooth was pulled, but now there's a new one.) No one in the family has anything like it in terms of bad teeth. As best we can tell the two week period where he had the ileus (and consequently lots of stomach acid in his mouth) must have damaged the enamel in his teeth. He occasionally has tooth pain from this but in those cases we feed him liquid food (protein shakes, yogurt, stuff like that). We are continuing to address his dental issues aggressively. Meanwhile, he's still small, but this is actually a common occurance in our family. His siblings and most cousins were at the low end or below the weight charts. My older kids always wore their age in clothing sizes. In the context of his illness/weight loss, steady recovery and sibling history his size doesn't concern me... but it obviously concerns the doctor. So... in this context, what do you suppose a high platelet count means? His doctor said to finish the teeth thing (that'll take two or three more months) and then we'll retest the platelet count. The doctor didn't discuss with me the implication of a high platelet count but I understand it might mean CML. (I asked him specifically about the meaning of a high platelet count but he was actively trying NOT to scare me and didn't want to get into scary cancer talk about one test.) If it were CML wouldn't my son appear unwell? And doesn't the white blood count get affected by that? Would it have anything to do with his size or his bad teeth or peritonitis? (I just can't see it!) What do you think? Wendy |
#2
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High platelet count/CML question
When I did a search for high platelet count, there was mention of Kawasaki's
disease and bacterial infection someplace in the body, like pneumonia. If you would like to see the web site I went to it is http://www.sma.org.sg/smj/3911/articles/3911a2.html Another site that had good information and one that describes much of what you describe is http://www.ehendrick.org/healthy/001352.htm The technical name for high platelet count is thrombocytosis. So you can do more research if you like. I would be more worried about the low iron and would probably start giving either higher iron foods or iron vitamins. In my reading, it seems the high platelet count could be attributed to low hemoglobin. We have the opposite problem as you, my daughter has extremely low platelet count and is very anemic. Good luck, I hope you find a cause. But, mostly it looks like unless there are other problems occuring, the high platelet count is not one to be very worried about. Remember too that anemia can result in a low appeitite and perhaps that is why he is small. Is he tall? -- Sue (mom to three girls) I'm Just a Raggedy Ann in a Barbie Doll World... Wendy wrote in message ... I've got a small four year old. He weighs 28 pounds. Two years ago he weighed 26.5 pounds. My doctor is very worried about this. He asked for a CBC count. It came back with lowish iron: 11.3, normal white blood: 6.5 and high platelet count, 514 where 150-400 is normal. I'm trying to put this in context and figure out what next to do with him. I'd appreciate any perspective or insight. This has us all puzzled. The child acts well, eats normally (sometimes he has an appetite, sometimes he doesn't) and has normal energy levels. He doesn't get sick easily (and hasn't had a cold yet this fall.) He has no trouble keeping up with his active preschool class. He doesn't need naps. But he's got two bizarre health problems: a year ago he nearly died from a perforated intestine and the resulting peritonitis and we have never figured out what caused the perforations (there were several small ones in his upper intestine.) At that time he had an ileus for about two weeks and lost quite a lot of weight - he has regained it all and doesn't appear to be skeletal, he's just SMALL. The other bizarre health problem is his teeth are shot. Just before he turned four he suddenly presented with five cavities and an abscessed tooth. We were never lax about his everyday dental care but in the past four months (since this problem suddenly developed) we've been totally anal about brushing and flossing and fluoride. And yet new cavities are still showing up and now he's up to SEVEN cavities with two abscesses. (Well, one abscessed tooth was pulled, but now there's a new one.) No one in the family has anything like it in terms of bad teeth. As best we can tell the two week period where he had the ileus (and consequently lots of stomach acid in his mouth) must have damaged the enamel in his teeth. He occasionally has tooth pain from this but in those cases we feed him liquid food (protein shakes, yogurt, stuff like that). We are continuing to address his dental issues aggressively. Meanwhile, he's still small, but this is actually a common occurance in our family. His siblings and most cousins were at the low end or below the weight charts. My older kids always wore their age in clothing sizes. In the context of his illness/weight loss, steady recovery and sibling history his size doesn't concern me... but it obviously concerns the doctor. So... in this context, what do you suppose a high platelet count means? His doctor said to finish the teeth thing (that'll take two or three more months) and then we'll retest the platelet count. The doctor didn't discuss with me the implication of a high platelet count but I understand it might mean CML. (I asked him specifically about the meaning of a high platelet count but he was actively trying NOT to scare me and didn't want to get into scary cancer talk about one test.) If it were CML wouldn't my son appear unwell? And doesn't the white blood count get affected by that? Would it have anything to do with his size or his bad teeth or peritonitis? (I just can't see it!) What do you think? Wendy |
#3
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High platelet count/CML question
In ,
Wendy wrote: *I've got a small four year old. He weighs 28 pounds. Two years ago he *weighed 26.5 pounds. My doctor is very worried about this. He asked for *a CBC count. It came back with lowish iron: 11.3, normal white blood: 6.5 *and high platelet count, 514 where 150-400 is normal. Is your pediatrician concerned regarding the thrombocytosis? Frankly, I don't think it's so very high. Only 95% of "normal" patients will fall inside a "normal" range, by the very definition of normal range, anyway. In the absence of bleeding problems, I have a hard time imagining you're dealing with a platelet leukemia, because neoplastic platelets are generally dysfunctional. With a normal white count you couldn't possibly be dealing with a chronic myelogenous leukemia, I don't think! I know that in the dog, iron deficiency can cause thrombocytosis. Is that not the case in humans? That would be the simplest explanation I can think of. That, or benign reactive thrombocytosis, seen sometimes with various inflammatory conditions. Good luck getting to the bottom of things! -- hillary israeli vmd http://www.hillary.net "uber vaccae in quattuor partes divisum est." not-so-newly minted veterinarian-at-large |
#4
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High platelet count/CML question
In article , Wendy says...
I've got a small four year old. He weighs 28 pounds. Two years ago he If it were CML wouldn't my son appear unwell? And doesn't the white blood count get affected by that? Would it have anything to do with his size or his bad teeth or peritonitis? (I just can't see it!) What do you think? Hi, Wendy. Those more knowledgable seem to have given you some encouraging responses. What I have to give you is just to take everything one step at a time through this process of differential diagnosis, and try not to think ahead of things as much as you can avoid it. For sanity's sake. I went through a similar scare some years ago as my son was presenting very atypically with a single enlarged tonsil, and the ENT was mentioning the possibility of a lymphoma. Eventually, the cause turned out to be an infection which was persistent and resistant to antibiotics. Sure I went to the internet and educated myself on lymphomas, but it was my father's advice not to think ahead of the process, and best I can not to pay the interest of worry on a problem that never came due. One step at a time. Cheers, Banty |
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