Help with blood test results please (pics)

[Claw001]

Could someone please help with these results?

I’m not an expert, however what Paediatrician has wrote in his covering letter, seems to conflict with actual results and comments?

Yes Coeliac is top of my list. There does appear to be a link. Can I ask Dermatologist about testing for this?

It’s quite frustrating! On Wednesday we had an appointment with a ‘Dermatology’ GP. I mentioned Coeliac and tried to show him letter from Paed, he dismissed this and refused to even look at the letter! Telling me not his dept, go back to my GP!

He then applied parafin based cream to my ds’s face, despite me telling him, he recently had a severe reaction, when my GP did the same. Next day, we ended up in a&e, allergic reaction, with ds’s face, bright red and swollen and his eyes swollen shut.

My faith in professionals is wavering!

There is a skin rash that is linked to coeliac disease. www.coeliac.org.uk/coeliac-disease/about-coeliac-disease-and-dermatitis-herpetiformis/dermatitis-herpetiformis/

No ask your GP about coeliac testing. It's a blood test.

Every referral to a consultant has to be done via your GP.

It looks similar. The forehead photo, he has this all over his face.

Arm photo, all over his upper torso.

posh hospital consultant made urgent referral to Dermatologist on Wednesday. Was told should hear within a week. Can Dermatologist order blood test?

As a couple of people upthread have said the lab results and comments are just that, results and comments of the 'raw' data.

This is quite common, eg my background is reading ECGs, things that I would flag as abnormal in adults are normal in children and some 'changes' are actually dependent on race.

sassh I get that the comments are based on the data. I’m questioning why paed has not picked up on these, as he is aware of the history.

He is aware that ds has been anaemic, had b12 and Vit D deficiency previously. Has an extremely limited diet. Ds was referred to him regarding severe fatigue and aches and pains, unable to attend school due to the fatigue etc.

As I said, im not an expert, however those comments based on the data seem very relevant to ds’s history.

Claw honest answer is I don't know, I guess he could but might tell you to go back to your GP.

You might be able to request the test over the phone to your GP surgery rather than in a face to face appointment. Then you might have the results to give to the dermatologist. It takes a few days to come back.

Why have they not done bloods for CRP?
What's your family history like for autoimmune diseases?

Don't stop him eating gluten before any test though as they need the antibodies to be high to show on the test.

What does your DS's diet actually consist of? Could it be a lack of nutrients that is the underlying issue rather than a medical problem?

posh ok thanks, my GP does nothing over the phone! I will make an appointment.

meetjoe no they haven’t. No family history of autoimmune. Family history of thyroid problems (women though my aunt and my sister)

Fret most definitely. That’s why I’m surprised paed didn’t pick up on the comments. Ds’s diet consists of breakfast dry toast, lunch croissant, crisps, grapes. Dinner chips, salad and alternates bacon, chicken nuggets and garlic bread. Snacks of crisps, the occasional biscuit or certain sweets. Very occasionally apple slices. This diet is a huge improvement, believe it or not! It’s a sensory thing. Been working with OT’s for years to improve his ‘beige’ diet. I have just had private OT reports done, for his EHCP, so OT input can increase.

Dietician has previously provided powder supplements which you mix with water and drink. Ds could not tolerate it and it doesn’t come in tablet or medicine form.

As you can see his diet is packed with gluten. He does has an history of ‘toileting’ difficulties too.

Will he take any multivitamin or mineral supplement?

He is certainly lacking proteins, essential fatty acids, omega 3/6, vit A, C,E zinc, magnesium etc.

Will he eat dairy, eggs or nuts or fish?

What are his nails, gums, and hair like?

He will take any form of tablets. At the moment just over the counter ones.

No he won’t, that is exactly everything he eats. I had some limited success with nuts at one point. OT explained it to me as ds’s fluctuating sensory system ie food one day it will taste and feel exactly like a nut, the next it could taste and feel totally different, even repulsive and could be like asking someone to eat a bowl of worms. I’m currently fighting to get more OT support into his EHCP, so his sensory needs can be addressed in school too. OT has written to be successful his sensory difficulties, need addressing across the waking day.

His hair, nails seem fine. I will have to look at his gums. He is extremely white and pale. Always has been. He won’t expose his skin at all ie joggers and long sleeves, regardless of the weather. He hates ‘outside’ too or daylight or any bright lights.

Hi I'm no expert but can share what happened with my dd, age 13 now,similar story. She had severe fatigue, abdominal pains from mild constipation a couple of years ago, paediatric dr picked up she was positive for the thyroid antibodies and had borderline hypothyroid results. They repeated the bloods a couple times I think every 3 months and eventually the bloods showed her thyroid had failed enough to start on thyroxine.
Once she started on treatment they did blood tests every 6 weeks and the results were different every time, high then low tsh,but they said this is what happens with the auto immune type of hypothyroidism. They gradually increased her meds and she is now pretty well and mostly back to her usual self. She still has periods of sleeping more especially after school.
Unfortunately I have found sometimes only time will tell, it's v frustrating though. My dd is also autistic and has a fairly beige diet too, I give her a daily good quality multi vitamin but I've got no chance of her going gluten free which I've read is the best thing for autoimmune conditions although her endocrinologist did not recommend this.
Hope you get answers soon.

I'd second an antibody test but actually unless his multivitamins contain iodine and selenium it's possible he's flagging a bit in those areas which could impact thyroid a bit.

I must say my nails flaked a lot though. Currently really strong and I'm euthyroid.

Constipation is definitely a symptom however I teach children with autism and I know this is not uncommon too due to anxiety and then the bowel gets used to withholding.

The gluten thyroid connection is that some people who are genetically disposed to coeliac disease may also have a higher chance of getting autoimmune thyroid issues too; some evidence that dealing with the gluten early enough can avoid this but I honestly don't know much more.

But you must keep the gluten up before any tests.

If he takes a multivitamin, is is a full range?

I was also thinking low vit a can lead to very dry skin issues.

B12 and foliage very low. Need to test for pernicious anaemia.

FT4 too low, which generally means low FT3 which causes, among other things, fatigue and aches and pains all over.

Any family history?

Tsh varies wildly in children according to this study; I expect as they have growth spurts it increases at times to stimulate the thyroid. The study mentions also responding to iodine and selenium status.

www.ncbi.nlm.nih.gov/pmc/articles/PMC2645400/

Key things to look out for are slow bone growth, (so small stature, slow growth), constipation and delayed puberty.

I had all of these. I was a latish developer at 16, still growing at 18 and became hypo at 21.

Interestingly I never experienced pain when very hypo; just chronic fatigue, foggy thinking and muscle weakness. It was only in my very late 30s (post child) I felt any aches linked to not enough thyroxine. Ive always assumed it's listed as a symptom as it's usually middle aged women who get it, often after children or during menopause.

Tsh varies wildly in children according to this study; I expect as they have growth spurts it increases at times to stimulate the thyroid. The study mentions also responding to iodine and selenium status.

www.ncbi.nlm.nih.gov/pmc/articles/PMC2645400/

Key things to look out for are slow bone growth, (so small stature, slow growth), constipation and delayed puberty.

I had all of these. I was a latish developer at 16, still growing at 18 and became hypo at 21.

Interestingly I never experienced pain when very hypo; just chronic fatigue, foggy thinking and muscle weakness. It was only in my very late 30s (post child) I felt any aches linked to not enough thyroxine. Ive always assumed it's listed as a symptom as it's usually middle aged women who get it, often after children or during menopause.

Sorry for double post, so I imagine it must be diagnosed through antibody tests and t4 levels, as well as symptoms.

ildaogden Glad you’ve got it sorted now. Yes we would definitely struggle with gluten free diet too!

Thanks all, plenty to think about and questions to ask. Thank you all again.