Abnormal Blood Test Results in Children: Next Steps

Blood test report

Hello, Doctor: Recently, my 10-year-old son had a nosebleed that was difficult to stop (he has had frequent nosebleeds before, and the pediatrician said it was due to thin blood vessels).
We took him to a medical facility for treatment.
Blood tests were performed, and after the ENT specialist stopped the bleeding, they said there were no abnormalities in the nasal cavity and let us go home.
However, a few days later, I checked the blood test results on the National Health Insurance translation service and found two abnormal items.
The test results are as follows: Platelet: 243 (normal range 140-450), WBC: 4.7 g/L (normal range 4.0-12.0), Eosin: 1.0% (normal range 0-5), Lymp: 44.8% (normal range 20-40), Mono: 7.7% (normal range 0-10), Seg: 45.9% (normal range 55-75), Baso: 0.6% (normal range 0-1), INR: 1.09 (normal range (-) (1.19)), PT control: 11.0 (normal range (-) (-)), PT patient: 11.0 (normal range 8.0-12.0), APTT control: 30 sec (normal range (-) (-)), APTT patient: 25.0 sec (normal range 23.9-35.5), Hemoglobin: 14.4 g/dL (normal range 11.5-14.5), Ht: 41.8 g/dL (normal range 33-43), MCV: 83.2 g/dL (normal range 76-90), RBC: 5.03 g/dL (normal range 4.5-5.7), RDW: 13.2 g/dL (normal range 12.3-17.0).
The Lymp and Seg values are both outside the normal range.
I would like to ask the doctor if further testing is needed regarding the abnormal results in the blood report, and which specialty should we consult?

You Chen, 40~49 year old female. Ask Date: 2022/09/06

Dr. Xiao Kaiwen reply Pediatrics

The results of these two tests are not far from the normal values and are within an acceptable range.
I believe there is no need for further testing.

Reply Date: 2022/09/06

More Info

When interpreting abnormal blood test results in children, it is essential to consider the context of the symptoms and the specific values that are outside the normal range. In your case, your 10-year-old son has a history of frequent nosebleeds, which can be concerning, especially when combined with abnormal blood test results.

From the results you provided, the two values that are outside the standard range are the lymphocyte percentage (44.8%, with a normal range of 20-40%) and the segmented neutrophil percentage (Seg, 45.9%, with a normal range of 55-75%). While these deviations can indicate potential issues, they are not definitive on their own and should be interpreted in conjunction with clinical symptoms and other laboratory findings.

Understanding the Results
1. Lymphocytes: An elevated lymphocyte count can indicate a viral infection, chronic inflammation, or, in some cases, a hematological condition. However, slight elevations, especially in the context of a recent illness or infection, are often not concerning.

2. Segmented Neutrophils: A lower-than-normal percentage of segmented neutrophils can suggest a variety of conditions, including a response to infection or inflammation, but it can also be a normal variant in some children.

Next Steps
Given that your son has a history of nosebleeds and the current blood test results show slight abnormalities, it is advisable to follow up with a healthcare professional. Here are some recommended steps:
1. Consult a Pediatric Hematologist: Since the blood test results are related to blood cell counts, a pediatric hematologist can provide a more detailed evaluation. They can assess whether the lymphocyte and neutrophil levels are clinically significant and whether further testing is needed.

2. Monitor Symptoms: Keep an eye on your son’s symptoms. If he experiences more frequent or severe nosebleeds, or if there are any other concerning symptoms (such as fatigue, bruising, or infections), it is essential to report these to the doctor.

3. Repeat Testing: Depending on the pediatric hematologist's assessment, they may recommend repeating the blood tests after a certain period to see if the values normalize or if there are any changes that warrant further investigation.

4. Consider Other Factors: Discuss with the doctor any other factors that might contribute to the symptoms, such as environmental factors (dry air, allergies), dietary considerations, or family history of bleeding disorders.

Conclusion
While the blood test results show some abnormalities, they are not necessarily indicative of a serious condition. However, given your son’s history of nosebleeds and the abnormal values, it is prudent to seek further evaluation from a pediatric hematologist. They will be able to provide a comprehensive assessment and determine if any additional tests or interventions are necessary. Early intervention can help address any underlying issues and provide peace of mind for you and your family.

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