Can you answer some questions about my 3 year old son's abnormal cbc?

Question

He had it check becase his iron was low 3 months ago and has been taking iron daily to bring it back up. Well I got his results after his test and I won't get to talk to his doctor until tomorrow. His RBC is low (4.49) so I gues that means he's still not getting enough iron.SEGS arelow (27), I have no idea what that means, LYM are high (59) dont know what that means either, LYMA should be 0 but he got a 4 and I don't know what that means RBC MORPH is abnormal and MICROCYTOSIS is 1+ and i dont know what that means either. Please help me and let me know what this means, thanks

Answer 1

You note that your son has low levels of Iron and he's been taking iron.

Microcytosis is a common finding of iron deficiency anemia when counting and sizing the Red Blood Cells.

Iron is one key ingredient in hemoglobin - the molecule that transports oxygen in

I would not worry about the Lymphs being higher than the Segs.  This is completely normal for a child.  When you son gets older (early teens or so), that ratio will flip and Segs will become the predominant White Blood Cell.

Lymphs are the white cells that help fight viral infections.  Segs (Segmented neutrophils) are the primary defense against bacterial infections.

I think you are going to have to continue with the iron therapy (but I would ask if there are any conditons that would prevent the Iron he's taking from being absorbed OR (more importantly) are there any reasons that he cannot retain the Iron he does have?  3 months should be sufficient to get the iron levels back to normal if he's not continuing to lose iron due to some other condition.

BTW, the LYMA is not a test for Lyme disease.

Each CBC instrument manufacturer has their own abbreviations, but I suspect that LYMA is an abbrevation for Lymph - Abnormal.  This just means that those particular lymphs did not fit the text book profile of a normal lymph (Usually the ratio of nuclear to cytoplasm volume is used).

Again, its normal for your child to have a higher lymph count; I think it is nothing to worry about by itself.

Answer 2

OK, one by one:

The low rbc count indicates anemia.

Rbc morph refers to the shape of the rbc's in his blood.  Normal rbc's have a specific size, and are nice, round, biconcave discs.  The microcytosis means his rbc's are smaller than normal.  I would also guess that if the anemia is due to iron deficiency, then somewhere on the cbc it should also say hypochromic, meaning that the rbc's aren't red enough because of the lack of iron (iron is what makes blood red).  The 1+ means that the microcytosis isn't that profound.

I'm not sure what LYMA refers to, but could it be a Lyme Disease titer?  If so, a high LYMA would indicate the kid has Lyme Disease.

High lymphocyte counts and low segs suggests that your baby may have a viral infection of some type (a cold, perhaps, or mono?).  Lymphocytes are the cells that fight viral infections, while the segs are the cells that fight bacterial and fungal infections.  Usually there are more segs that lymphs in the circulation.

Hope this helps.