Hello Everyone!
Thank you all for replying and caring, even though you are all dealing with so much yourselves. It is a welcome change to talk to others who must deal with so many healthcare issues also.
We have finally found a case manager - what a relief to some extent. Instead of all these different specialists' not conferring with one another we now have a consultant pedatrician who is looking into a case conference between all of the various specialist's we have already seen & hopefully find some answers - but we were informed yesterday that we need to prepare ourselves for the chance that there may not be any, at least any time soon.
So on to some results:
Recent Previous (over the past 2 yrs)
WBC 4.4 6.3, 5.5, 5.9, 4.3
RBC 4.34 4.39, 4.15, 3.81, 4.27
HGB 127 126, 118,106,123
HCT .366 .37, .352, .33,.36
MCV 84.3 83, 84.4, 86,83
MCH 29.3 28.7, 28.4, 27.8, 28.8
Platelets 244 217, 405, 365, 298
Differentials:
Neutrophils 1.93 3.6, 2.85, 3.4, 1.6
Eosinophils .16 <.1, .56, .5, .1
Basophils .03 <.1, .05, <.1, <.1
Lymphocytes 2.08 1.8, 1.67, 1.1, 2.2
Monocytes .30 .9, .37, .9, .3
Reticulocyte count 44
ESR 50, 8
INR 1.1
aPPT 33
Ferritin 78
C Reactive Protein Rapid <5 , 1.0
C3 1.12
C4 .44
CK 25
ANA Equivoval Titre 80 Pattern Homogeneous - previously Negative
ENA Negative
Rheumatoid Factor <10
Bone Marrow
Aspirate Excellent
Biopsy Good
Total Cellularity Reduced
M/E Ratio Normal
Megakarycocytes Present
Bone Marrow Differential
Neutrophils 14
Lymphocytes 32
Band Cells 20
Eosinophils 4
Metamyelocytes 10
Pronormoblasts 2
Early Normoblasts 2
Intermediate Normoblasts 7
Myleocytes 6
Late Normoblasts occ
Promyelocytes 2
Blast Cells 1
Few reactive lymphocytes present, no abnormal circulating cells
M/E ratio appx 5:1 considered high normal
Granulopoiesis generally noroblastic with occasional megaloblastoid forms
Granulopoiesis orderly maturation
Megakaryocytes are present and show normal morphology
Lymphois cells appear mature with occassional hematogones noted
Blast cells are not increased
Few cells that appear to be larger lymphoid cells, however no cells foreign to bone marrow present
Cellularity 30 - 40%
Moderate focal aspiration and hemorrhagic artifact
Trilineage hematopoiesis is presesnt with small erythroid islands, regions of granulopoiesis and scattered megakaryocytes
No abrnormal infiltrate identified
hypocellular areas are composed of unremarkable fat cells
Comments:
Bone marrow does not show any morphological evidence of malignacy. Occassional lymphoid cells that appear larger and few show slightly irregular nuclei.
Flow Cytometry does show presents of hematogones however no abnormal lymphoid population is identified
The cause for hypocellularity for age is not morpholically apparent. May be due to reactive phenomenon due to systemic illness. Although early bone marrow failure syndrome cannot be entirely excluded it is noted the the peripheral blood counts are unremarkabe and this diagnosis is not favored at this time.
We are currently undergoing more testing for metabolic & biochemical diseases but will not have those results for 8 weeks
I really appreciate all of your thoughts, comments etc. One thing of note is that my son have multiple protein intolerances and major allergies. The Drs & I are querying whether his blood counts would be 'off' dur to this. Allegies increase WBC and with his allergies they actually expected to see very high WCB....
On a great note, McLean gained his 1st pound in over 2 years!!!! Strangely enough it was during his worst appetite weeks.
Again thank you,
Shawna
Mother of McLean (4.75 yrs) In addition to his undiagnosed illness he is Anaphalactic to Dairy, Goats milk, Soy, Almonds, Severe allergies to Egg yolk, peaches, pears, plums, flax, turkey