Help me understand the abnormal. Blood results

[Grenola]

So my son has been ill. Since October. Admitted to hospital in November with an acute kidney illness where they didn't filter properly. Caused blood and protien on urine and caused very high blood pressure. Since discharge he has been checked weekly at the ward and this week was his last one. He is to be reviewed next week and next course of action decided. He has had 7 full. Blood count tests done and 3 full panel. Immunology resits. But I have only be able to get home of his full blood count from Jan 4th.
Im.so worried about him, he is better but so pale, puffy and tired all the time. Had nose. Bleeds joint pains and odd rashes.

The main abnormailities are he has high platelets and low white blood cells. And a few borderline results right on the lower cut off.

Anybody with experience of what he could have? It's making me ill now as its dragged on eitbour any answers....
He is 5 BTW. And yesterday his BP was 118 even with his high dose of BP medicine

Has he had a coeliac test ? Bit left field but can cause rumbling isdyes
But as he had kidney isdue youneed to wait to soeak aith his paediatrician
Dont let them dischRge you
Write down all your questions

No, he hasnt. Well. He might have but they aren't telling me Anything.
I do worry that the kidney doctor will his kidney function is better and try to discharge. Will make sure they don't x

You might need general paediatrician

Have they ruled out Hemolytic Uremic Syndrome?

My DS has nephrotic syndrome, has this been ruled out for your DS?

Yes, I think the nephrologist will discharge him to the medical pead team maybe?

He has a diagnosis as acute glomerulonephritis currently but they need to find evidence of it before the settle with this. And I don't think it accounts for the blood counts.

@Anyonebut I haven't heard of that. They haven't said what they have ruled out. I'm. Pretty much been left in the dark with the most worrying thing for hem has been kidney function retiring.

@Cactusowl it this a chronic illness? How do they treat your son?

I am by no means an expert, but HUS has 2 forms a more acute one following infection (in many cases from ecoli) and another one not related to infection. The symptoms and test results you mention could indicate HUS, but they probably can indicate a whole range of things, I do not have a medical background.

For the more acute one, it normally starts with a sudden bout of bad diarrhea.

I know someone diagnosed with the 1st type over 30 years ago and I do know the correct diagnosis took a while, but they probably are better at diagnosing it now.

Thank you, that helps a lot.

At the moment they are considering a possible post strep reaction. But he didn't have a strep infection well wasn't treated for one and one didn't show on the blood results.
I will Mention this to the nephrologist.

I was thinking maybe an auto immune disease, like lupus as it presents as nephritis too. 🤔
Its def not going to be simple is it. I just want reassurance that he isn't in any danger for silent symptoms.

If they suspect reaction after strep infection it looks like they are possibly considering/ruling out HUS, but no harm in asking.

I hope you get answers soon and that Ds starts to feel better.

I am peadiatrician
High platelets and low WBC s usually a sign of inflammation, perhaps a viral illness ? Increased platelets are very common and often a non specific sign. How high are we talking 500 is very different to 1200 ? Similarly are the WBC low like 4 or 5 ? or less than 1 ?

Platelets are 690
Wbc 3

X

DS was in hospital with acute glomerular nephritis when he was 11. He had the exact symptoms you describe - high levels of blood and protein in his urine and v v high blood pressure - life threateningly high at times. A couple of weeks before he had a virus and doctors concluded it was an auto immune response - I think it was called iGa. He was blue lighted from our local hospital to the Evelina in London. He was there for 10 days until they had sorted out medication to lower his blood pressure, then was under the care of the local hospital and then the GP. He was generally ill for weeks afterwards - dizzy, headaches, breathless, feeling sick - but eventually made a full recovery. He is 15 now and has had a couple of relapses but nothing like as bad as the first time. I think puffy face may be side effect of medication possibly.

Neither of those are dangerously outside of normal range, but I would be repeating them to see the trend.

@TAmumto3
Thanks for that, that's reassuring that your son was also ill for a long time after. Hate seeing him so weak.
Can you remember how long his BP was high for?

@babyyodaxmas thanks. This is his 4th repeat so hopefully they can see the trend.

Will speak to nephrologist on Thursday.

But feel much less worried now.

He also had joint pains, swollen joints and a rash that came and went. Blood pressure peaked at about 250/145 - it was quite traumatic as he was on all kind of obs as doctors were worried about heart or brain damage from the blood pressure. He is happily and loudly playing fortnite now! Hope you son recovers soon.

Wow, that is high. My ds rezched 180 and medication wasn't touching it. He was vomiting constantly at this point and his nose was bleeding. Urgh so horrible.

X

Fanconi syndrome?

Has he had a temperature at all? Have a look at systemic juvenile idiopathic arthritis SJIA. It is characterised by cyclical temperatures, joint pain and sporadic rashes..... but the systemic part means that it is not just effecting your joints, but the inflammation can effect organs too. CRP, ESR may be high. There is also something called ferritin that can be measured in blood tests and if this is high it can also be an indicator. MAS is a complication of SJIA which needs to be looked out for as it can be quite serious.

He did have temperature at the beginning which went and then kept spiking.
His kidneys were very inflamed on the ultrasound.
So something systematic is going on.
Think he did have ferritin measured.
I will ask about this.

Thanks

I hope you get to the bottom of it. It’s horrible when there is not a simple diagnosis. Sjia is diagnosed by the exclusion of other things (including a bone marrow biopsy to check for luekemia). It is quite rare - a paediatric rheumatologist would be your best chance of diagnosis if it is that. Are you under a big hospital? My son was diagnosed at a local hospital, but that was after dialogue with the specialists children hospitals in London and Southampton. I’d be interested to hear when you find out what’s wrong. Good luck. X

His is under the Birmingham children's. With an amazing renal team, bit think the. Nephrologist will refer him on.
Will. Keep u posted x

@beckypv
Just looking again, and it does actually match a lot of his symptoms. Weakness and stiffness in legs, nighttime temp and hallucinations/night terrors. Rash that comes and goes. Limited movement in his knees and legs when lifting or vending.
His crp hasn't been too high tho and his white blood count isn't high.
Worth being on my radar Tho thanks xx