Monday, June 18, 2012

White Blood Cell Count Concerns (and a correction)

Just popping in here to correct something from a previous post. I stated that a normal white blood cell count reading was about 5,500. I've now researched this quite a bit: the normal range is actually between 4,000 and 11,000. A typical reading for a three-year-old child is about 9,200.

Beth's reading was high in February and April (23,000 and 24,000). Any reading over 15,000 begins to concern doctors. Readings over 30,000 can be indicative of a bone marrow disorder such as leukemia. Other markers for leukemia were normal for Beth, but there is one type, chronic leukemia, in which only the white blood cell count appears abnormal.

So wow...I can't even rule out leukemia.

As much as I'm praying and trying to feel peace, the blood tests results? Worrisome.

I spoke with a nurse at the rheumatologist's office and learned that Beth's doctor wrote in the chart: are we missing a tumor or cyst in her knee?

She'll order an x-ray and possibly send Beth to a hematologist if the next reading is also high.

Funny how they write such things in their notes, but don't tell the parents anything? Don't you love medicine? Too much information isn't good, but too little can be even worse.

For the record I looked up pediatric knee tumors and thought it unlikely in Beth's case. The only red flag is her rapid growth in height, which sometimes put kids at greater risk for tumors. Most pediatric knee tumors occur in teenage boys with growth spurts.

The rheumatologist didn't mention this, but I've learned that Prednisone--given to Beth in late January/early February for 9 days because of a particularly bad arthritis flare--can cause high white blood cell counts. How high and for how long seems to be an individual thing. This would be an unusually long-term reaction to Prednisone, so the doctor's discounting it...not even mentioning it? Or she didn't review the chart from January and she forgot the prednisone? There are too few pediatric rheumatologists in the United States (most have high case loads).

NSAID's (she's been on naproxen for many months) can also cause higher counts, but not this high. Auto-immune diseases and inflammation can also contribute to higher readings, although most Juvenile Rheumatoid Arthritis patients have normal white blood cell counts, despite chronic inflammation.

She doesn't seem sickly and she's quite active--even using her knees better than she has for months. There's been a slight weight gain recently and she's grown three inches, making her quite tall for her age. The pediatrician said Beth's weight is only 1.5 pounds lower than average (at just over 30 pounds). He's not concerned about weight gain and doesn't think I should be, since we're all on the skinny side.

Don't you love that they look you over to decide what your child's weight should be? My Mary is packed with muscle and doesn't look skinny at all, at 5.5 years old and 42 pounds (about average). Hopefully the pediatrician doesn't make any comparative comment in front of Mary at her upcoming physical. I don't want an eating-disordered child who became sensitive when her doctor said she wasn't skinny "like the rest of us".

Sorry for that digression....Anyhow, I want to think the abnormal white blood cell readings are a combination of a lot of different things, but mainly an unusual reaction to oral Prednisone.

I will have her blood test repeated this week (the third time). Please pray for peace of mind? And no more health issues for Beth? Thank you.

How can I pray for you? I am faithful and it's worth the effort to share. Comments are on delay and I won't post prayer-request comments. Bless you, friends.

P.S. I really do like our pediatrician. 


Lisa said...

Still praying for little Beth. Glad to hear that she's not in the midst of a a flare anymore. :)
Thanks for keeping us up to date on what's going on with her. Praying for you, too..for peace in this situation.
(Isaiah 26:3)

Christine said...

Thank you, Lisa. I appreciate the prayer very much. Love to you!

Holly said...

Praying for your family. I hope you get all the answers you need. Isn't the internet a double sided sword. My little one gets a test and I get a short message with numbers and data. Seeking info leads to so much more that my hubby threatens to disconnect me from internet until our dr appts come. Your post just made me feel not alone. I research, think and pray and worry. Somehow, I feel the need to know for my son's sake. I pray for peace and wisdom for you. I know how hard it is to not worry or fret. God lets me fret and drive myself mad with a ton of information and then he just whispers "I am here and directs me in the right direction. It has been a running joke in my family- I need to fret and gather all info I can get my hands on until I stop and listen.
I hope you have a wonderful and pack it full with lots of loving moments. Your post really helped me today .

Christine said...

Dear Holly, thank you for commenting here. My daughter's level did go down to 18,000 at last check so we are no longer worrying. I pray your son's tests turn out to be benign worries. Love to you.