Blood Test Results for a 5-Year-Old Boy with Suspected IgA Nephropathy

Blood report of a 5-year-old boy?

Dear Doctor, a 5-year-old boy is suspected of having IgA nephropathy.
After a blood test conducted by the physician, the nephrologist only mentioned that kidney function is normal.
However, upon reviewing the report, there are several values that are either elevated or decreased.
What does this indicate? Is there a need to follow up with another specialty? The blood test results are as follows: white blood cells 7.8, red blood cells 4.81, hemoglobin 13.7, hematocrit 41.3, mean corpuscular volume 85.9, mean corpuscular hemoglobin 28.5, mean corpuscular hemoglobin concentration 33.2, red cell distribution width 39.3, platelet count 331, red cell distribution width coefficient of variation 12.4, PDW 8.3, MPV 8.7, neutrophils 41.1, lymphocytes 43.2, monocytes 8.2, eosinophils 6.3, basophils 1.2.
The hematocrit, mean corpuscular volume, monocytes, and basophils are indicated as high, while PDW and MPV are indicated as low.
Thank you, Doctor.

yuhan, 30~39 year old female. Ask Date: 2024/02/07

Dr. Xiao Kaiwen reply Pediatrics

This blood test should be a CBC/DC (Complete Blood Count/Differential Count).
Based on this report, the results are generally normal.
However, this blood test is only a very basic examination at the hospital.
If there are any significant discomforting symptoms, please go to the hospital for further detailed examinations.

Reply Date: 2024/02/07

More Info

When interpreting blood test results for a 5-year-old boy suspected of having IgA nephropathy, it is essential to understand the significance of each parameter in the complete blood count (CBC) and how they relate to potential health issues. The results you've provided show several values that are either elevated or decreased, which can indicate various underlying conditions.

1. White Blood Cells (WBC): The reported WBC count is 7.8, which falls within the normal range for children (approximately 5.0 to 10.0 x 10^9/L). This suggests that there is no acute infection or significant immune response at the time of testing.

2. Red Blood Cells (RBC): The RBC count is 4.81, which is also within the normal range for a child of this age. Hemoglobin (13.7 g/dL) and hematocrit (41.3%) are normal as well, indicating that there is no anemia present.

3. Mean Corpuscular Volume (MCV): The MCV is 85.9 fL, which is within the normal range. This indicates that the average size of the red blood cells is normal, which is important for diagnosing types of anemia.

4. Platelet Count: The platelet count is 331, which is within the normal range (150-450 x 10^9/L). This suggests that the boy does not have a bleeding disorder related to platelet function.

5. Differential White Cell Count: The differential count shows:
- Neutrophils: 41.1%
- Lymphocytes: 43.2% (slightly elevated)
- Monocytes: 8.2%
- Eosinophils: 6.3%
- Basophils: 1.2%
The slight elevation in lymphocytes could indicate a viral infection or a chronic inflammatory process, but it is not significantly high enough to cause concern. The neutrophil percentage is slightly low, which can occur in viral infections or after certain vaccinations.

6. Red Cell Distribution Width (RDW): The RDW is 39.3, which is elevated. This can indicate a variation in red blood cell size, which may be seen in conditions such as anemia or other hematological disorders.

7. Platelet Distribution Width (PDW) and Mean Platelet Volume (MPV): The PDW is 8.3 and MPV is 8.7, with the latter being low. Low MPV can suggest a production issue in the bone marrow or a response to certain conditions, but it is not definitive on its own.

Given these results, while the kidney function appears normal, the abnormalities in the blood count warrant further investigation. IgA nephropathy can sometimes be associated with other systemic conditions, and the presence of proteinuria or hematuria (which may not be reflected in the CBC) could indicate kidney involvement.

Recommendations:
1. Follow-Up Testing: It may be beneficial to conduct additional tests, such as urinalysis to check for protein and blood in the urine, and possibly a kidney ultrasound to assess kidney structure.

2. Referral to a Pediatric Nephrologist: Since there are concerns regarding IgA nephropathy, a referral to a pediatric nephrologist is advisable for specialized evaluation and management.

3. Monitoring: Regular follow-up appointments should be scheduled to monitor kidney function and any changes in blood parameters.

4. Consideration of Other Specialists: Depending on the results of further tests, it may also be necessary to consult a pediatric hematologist if blood abnormalities persist or worsen.

In summary, while the initial kidney function tests are reassuring, the blood test results indicate that further evaluation is warranted to rule out any underlying issues that could be related to the suspected IgA nephropathy or other hematological conditions. Regular monitoring and follow-up with appropriate specialists will be crucial in managing the child's health effectively.

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