Low neutrophiles and high eosonophiles!

Malika

Well-Known Member
I got the results of a blood test my son had done yesterday (he was truly so sweet and so brave while it was being done - remained stock still with his arm out, crying gently and pitifully). His hyperactivity is not due to thyroid problems - this is normal. However he has a very low neutrophile count and high eosonophile count (both out of normal range). Also low hematocrit level. This means absolutely nothing to me. I will see the doctor next week to have it all explained but wondered in the meantime if any scientific bods had any insight into this...?
 

rlsnights

New Member
When you say his neutrophil and eosinophil counts were high or low - was it the percentage that was high or low or the absolute counts or both? If the test that was done was a complete blood count with differential then both amounts should be included.

Low hematocrit usually means the child is anemic. If it's only slightly low it may also be that he was a little dehydrated when he had the blood drawn. If the level is low enough or other measures suggest it's anemia, the doctor will probably want to try to figure out why he's anemic. If he doesn't eat meat, especially red meat, then it may be that he needs iron supplementation. But there are a number of other possible causes of anemia and you will want to talk to the doctor about it to find out what the doctor thinks might be the problem. Do NOT start iron supplementation before he is seen by the doctor.

Generally speaking, eosinophils are associated with allergic reactions and inflammation. Since it's spring, they may be elevated simply because he is having seasonal allergies. And didn't you say he'd recently had a reaction to something that gave him hives? That is probably why they are elevated. There are lots of possible explanations for elevated eosinophils so I really can't say any more than that. You can read more about it online but I suggest you wait and see what his doctor has to say before you scare yourself reading about all the possible causes of elevated eosinophils.

If you PM me with the actual results and the reference ranges for each test I can suggest some questions you can ask the doctor if you like. But I am not a doctor and would not presume to offer medical advice.

It was very brave of him to cooperate with the blood draw but it's best not to make too much fuss over these things. They are just a part of life and it's good that he handled it well.

Patricia
 

Malika

Well-Known Member
Thank you for your very informative response. From what you have told me and a little light Google research I have been doing, I gather that low iron/anemia (which is what my son's blood test points to) can in itself be a cause of hyperactivity... I do need to talk to the doctor about that. I also read that ADHD children metabolise sugar differently to the norm?
 

rlsnights

New Member
I have never heard or read anything that found a reliable connection between iron deficiency and hyperactivity. There is evidence connecting low ferritin levels with restless legs symptoms in children with ADHD but not with ADHD itself - at least not that I am aware of. And low ferritin levels may or may not be a result of iron deficiency.

And it is too early to conclude that your son is anemic based on this one test result with mildly decreased hematocrit levels. And iron deficiency is only one cause of anemia. There are many, many others that have little or nothing to do with iron levels.

The regulation of iron storage and use in the human body is very complex and there are many different ways it can go a bit wrong. It's not really unusual for people, especially growing children, to sometimes be a little anemic and is easily remedied with dietary measures or a brief period of supplementation. But it's very important for this to be done under medical supervision because too much iron can be toxic and damage the liver very quickly.

I know it's hard, but I suggest you wait patiently for the doctor's appointment rather than do a lot of internet research on this.

Patricia
 

Malika

Well-Known Member
That's interesting, Patricia. I did see quite a lot of stuff about connection between low iron and hyperactivity... maybe these are British sites :) It wasn't just my son's hermatocrit (sp?) that was low but also the iron and the ferrotin in his blood - this does seem to point to anemia, no? But as you say, it's complex doubtless and really I have no basis of knowledge on which to speculate. Have made an appointment to see the doctor this afternoon as I am, yes, impatient to have this explained! Thanks again for your insights.
 

rlsnights

New Member
You didn't mention the other results which does seem to point to anemia. But the cause of the anemia is what will have to be explored or explained to some degree. If he ordered an iron transport study that should give him a fair amount of information to figure things out along with a physical exam and clinical history.

I did a brief google for this and found a handful of studies that had very small # of kids in the studies - as in 10 to 40 and the "power" of the studies was not very strong in the ones I had time to look at. I think that there has been a pretty good basis established for the need to check these levels in kids with ADHD but that's due to the impact of low ferritin on the quality of their sleep.

I will be interested in hearing what your doctor has to say. I'm glad you have an appointment today. I find it very hard to be patient myself. :hangin:

Let me know what he/she says. I've also found that there can be big differences in the treatment plans between European and US doctors.

Patricia
 

Malika

Well-Known Member
Well, we saw the doctor (who also looked at J's allergic chest!) and apparently there is absolutely no cause for concern about any of it because the results for children are, he said, always "out"... again apparently they only give the variable references for adults, not children. I asked if we should give an iron supplement - he didn't seem to think it was vital but did prescribe one. He is concerned, though, about the high glucose and has said we need to have a further blood test on these - two in fact, one before and after eating. J will not be happy and neither will I, with all the pre- and post-test nerves and upset :) I totally agree with you that these things are just part of life and not to be made much of - all that remains is for J to get on board with this opinion :)
 

rlsnights

New Member
Well, that's good news about the "anemia". Glad you have a well-informed doctor.

Has J ever had to do blood draws before?

You might want to call the lab where you will be going for those tests and ask them if they do anything special with children who are anxious about the blood draws. Here they will sometimes use a numbing cream called Emla to help take away most of the sting. It's a pain to use though. A heavy layer of cream has to be applied where they think they are going to draw the blood and then covered with a clear plastic bandage. It takes about 30 minutes to work and then the cream has to be wiped off before the draw can be done. So it prolongs the process which, if you're going to place an IV is OK but for regular blood draws it makes it take much, much longer.

He may take his cue from you. If you are able to be calm and matter-of-fact about it then he may do better. If you have any bloodwork that needs to be done, you might go at the same time. You could go first and show him how easy it is and that might reassure him.

You might plan a favorite little outing or treat to do after the blood draw but don't expressly connect it to doing the lab well. Just say well let's do this when we're done so he has something pleasantly distracting to think about. If you are going to get a treat like ice cream, when he's sitting there just strike up a casual chat about what kind of ice cream he will order or does he remember the last time you were there and you laughed about the silly little dog - anything pleasant but kind of low key that will keep his mind off what's happening. Sit so he can look at you when you're talking but has to turn his head away from the person doing the blood draw if you can. It is better, in my opinion, if you don't try to hold him on your lap which I have seen sometime done here.

You could try a small reward but I wouldn't do anything too big because you don't want to set him up for thinking that he deserves a big reward for this.

Last suggestion - you could give him a strong scented gum (Juicy Fruit works well) to chew right before he has the blood draw. The strong scent will distract his brain from the pain believe it or not. But it has to be timed very close together.

Good luck. I expect it will be fine. My son has had high glucose readings a couple of times and when we repeat the labs it is fine.

Patricia
 

Malika

Well-Known Member
Actually the doctor beat you to it, Patricia, by prescribing two patches that I stick on his arms an hour before the blood test and they will apparently deaden the pain... I also had him explain this to J - who will remember! To be honest I was so pleased (and relieved) that he didn't have a tantrum and was so co-operative when he needed to be that I did give him a special treat afterwards - he was allowed to watch a DVD, which he usually does only at the weekend and had a chocolate egg... Plus I said to him several times how brave and good he had been. So he will be fully expecting more treats for brave behaviour!
 

rlsnights

New Member
I'm sorry if I seem to be going overboard on the advice here. It's advice I wish someone had given me when we started dealing with serious health issues with my son. I don't mean to imply that your son is going to have problems but I learned the hard way that it wasn't helpful to any of us to teach my son that doing things like blood draws deserved a lot of special attention and that he should be rewarded for this.

At this point we have been able to drop back to blood draws every two months (from doing them every month for 18 months). He had to do daily shots in his belly at one point that was really difficult. And for almost 3 years we did shots in his belly every 2 weeks. And of course there were many invasive medical tests. So in the long run he had to learn that making a fuss about doing these only made them harder. But I think if we hadn't rewarded him so much at the beginning it would have been an easier lesson to learn.

Patricia
 

Malika

Well-Known Member
Thanks, Patricia, I appreciate it. Shots in the belly - poor child... I am sure you are right. Much better not to make much of it. Maybe I just have sympathy because I hate injections myself... maybe I'd like someone to buy me a chocolate egg after! But I will bear your advice in mind with the next two blood tests and play them down... I suspect I'll still be buying that egg though!
 
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