Worried over high WBC count

[LALove]

2 weeks ago DS (who just turned 3) became ill with a 104.5 fever and vomiting. He asked us to take him to the Dr so we did. We had to go to a local emergency clinic since it was Sunday and his regular ped wasn't in. They gave him Motrin to bring down the fever and ran tests to find the cause of the illness. Strep/flu came back negative. They also took a urine sample, blood sample and chest X-rays. Urine test showed nothing, X-rays showed nothing wrong, but his white blood cell count came back high at 27 (normal is below 10 I think). The Dr was kind of freaking out which didn't help me, of course. She said kids with severe pneumonia do not have this high of a WBC count and we'd maybe have to admit him to the children's hospital because of this and because she couldn't find the source of his illness. She left to talk to another Dr and came back much calmer. She told us to just go home and bring him back tomorrow for a follow up (unless his fever wouldn't stay down). I asked what was up with the WBC count and she said maybe due to DS being ill, which isn't what she said earlier. The next day we took him to his regular ped. She reviewed the test results from the ER and checked over DS. She couldn't find the source of his illness either but decided to put him on antibiotics in case what he had was bacterial and not viral. She said the other Dr probably freaked out because she was worried that DS may develop sepsis but she said he had 0 signs of that. She also said she didn't feel it was necessary to redo his WBC count as it was either most likely from being ill or a lab error.

DS recovered in a couple of days. I called his ped after he was done with his antibiotics and asked if she was sure we shouldn't redo the test. The nurse called back and said the Dr wanted to redo the blood test. When we went in, the Dr changed her tune from not being concerned with the high WBC count to telling me we need to test to make sure he doesn't have leukemia. DH thinks she just wanted to cover her rear end in case DS does have something wrong and she missed it because she didn't retest. But, it is kind of freaking me out that now she's concerned whereas before she wasn't worried at all.

I have to wait 2 more days for the test results and I'm really trying not to freak out. I know it's irrational to get upset before I even know if there's anything wrong but I can't help it.

I'd just like to know if anyone else has gone through this- an extremely high WBC count that ended up being nothing major (as in not cancer but just caused from being ill with a virus etc).

Thank you in advance.

Edit: I should add that DS is a very healthy, happy, active little guy and he's only been sick a handful of times in his life (most of them recently, having just started preschool).

 

[Munchkin]

Been there as both a parent and a provider

My kiddo's last WBC was 19+ so we are repeating it in 2 weeks. His platelets were also high which is evidence of an "acute phase reactant" meaning his labs were elevated in response to a newish, rather than a chronic issue.

If your son had leukemia, the differential run with the CBC would have revealed some wonky types of cells. If any of those had been seen, both the ER and your primary would have mentioned something much earlier.

I agree with your DH. I have a patient repeating a CBC in a week because his WBC was 20.4 when he came to see me with a fever. I'm repeating it just to make sure it trends back down after his body has had time to recover. I don't think he has leukemia, but I can't leave it be without double checking.

 

[LALove]

Been there as both a parent and a provider

My kiddo's last WBC was 19+ so we are repeating it in 2 weeks. His platelets were also high which is evidence of an "acute phase reactant" meaning his labs were elevated in response to a newish, rather than a chronic issue.

If your son had leukemia, the differential run with the CBC would have revealed some wonky types of cells. If any of those had been seen, both the ER and your primary would have mentioned something much earlier.

I agree with your DH. I have a patient repeating a CBC in a week because his WBC was 20.4 when he came to see me with a fever. I'm repeating it just to make sure it trends back down after his body has had time to recover. I don't think he has leukemia, but I can't leave it be without double checking.

Munchkin thank you sooooo much for taking the time to post this!! I could cry you've made me so relieved!!

I wish either Dr would have told me what it took you one sentence to explain (wonky cells) instead of just being really alarmed (ER) and telling me we have to check for cancer and leaving it at that (DS ped)!

Have you seen this before- a high WBC that was caused only by minor illness and not anything major? The ER Dr definitely made me feel like a count of 27 was catastrophic and couldn't just be a simple bug.

Again, thank you so much!!!!!

 

[LALove]

UPDATE: Just got off the phone with a nurse from DS's ped's office and his blood test results all came back normal! Thank goodness!! So, apparently, a run of the mill virus/infection can cause a pretty high WBC count.

 

[Munchkin]

YAAAAAY!!!!!

I'm a little late to the party, but yes. I have seen high WBC in kiddos with viral illnesses. I swear, some kids are just super reactive. Some kids are the ones that spike high temps with illness, some kids get big swollen lymph nodes with bugs and others can get elevated lab studies.

My kiddo tends to have platelets and fevers that skyrocket. We've seen immunology specialists and for him, it's normal.

One of the hardest parts of my job is reassuring parents that even though a child's labs are abnormal enough to warrant repeating, they are still normal[i[/i] enough that I'm not panicking. There is an immense amount of gray in lab interpretation. Until I can present a parent with a truly normal result, they tend to worry. A lot.

Edited. Apparently I can't spell the word "parts."

 

[diamondseeker2006]

Thank goodness! There is no way you couldn't be fearful in a situation like that! Glad it turned out well!

 

[LALove]

YAAAAAY!!!!!

I'm a little late to the party, but yes. I have seen high WBC in kiddos with viral illnesses. I swear, some kids are just super reactive. Some kids are the ones that spike high temps with illness, some kids get big swollen lymph nodes with bugs and others can get elevated lab studies.

My kiddo tends to have platelets and fevers that skyrocket. We've seen immunology specialists and for him, it's normal.

One of the hardest parts of my job is reassuring parents that even though a child's labs are abnormal enough to warrant repeating, they are still normal[i[/i] enough that I'm not panicking. There is an immense amount of gray in lab interpretation. Until I can present a parent with a truly normal result, they tend to worry. A lot.

Edited. Apparently I can't spell the word "parts."

Thank you so much! It's a relief to know that it can be normal ie not mean that there's something severely wrong!

I can imagine its hard to console worried parents - but kudos to you for taking the time to actually talk with them and give them all of the data. I had to google high WBC count and whoa- looking up conditions on the net is scary and upsetting!

Thank you again for reassuring this freaked out mommy!

 

[LALove]

Thank goodness! There is no way you couldn't be fearful in a situation like that! Glad it turned out well!

Thank you DS! Its been a rough couple of weeks and I'm so relieved DS is fine.

If all doctors handled their patients with care and compassion and took the time to go over things with parents like Munchkin, there'd be a lot less freaked out parents out there!