Elevated LDH Levels in a 7-Year-Old with Hemolytic Anemia History
Greetings, I wanted to share some concerns regarding my son's recent lab results, which indicated an elevated LDH level at 279, accompanied by notes of mild hemolysis. For the past two years, his ALT levels have shown slight elevation, recently decreasing from 35 to 26, which puts it just above the normal range. Additionally, he underwent an abdominal ultrasound in August, which showed normal liver function. His ferritin level is of concern as it remains low at 16. Currently, both his hemoglobin and RBC counts are within the normal range but on the higher side, with readings of 5.15 for RBC and 14.9 for hemoglobin. Conversely, his white blood cell count is slightly below normal at 4.9. Background: Last summer, my 7-year-old son was hospitalized due to a severe episode of hemolytic anemia. Thankfully, after receiving a blood transfusion, he improved well and required no additional medication, as the doctors attributed the hemolysis to a viral infection. Since then, we've been consulting various specialists due to some unusual lab findings and other symptoms he is experiencing. There is also a history of autoimmune conditions on both sides of our family. He has previously dealt with pancreatic insufficiency and took CREON for a while. However, a sweat test for cystic fibrosis returned negative, and a later stool sample showed normal results, leading to discontinuation of CREON. He frequently reports joint discomfort, particularly in his ankles, thoracic spine (where an MRI without contrast returned normal results), and neck. Additionally, he experiences significant gas, often resulting in belching and unpleasant flatulence. I feel like we’ve been seeking answers for quite some time and would appreciate any insights or experiences others might have regarding similar situations. Thank you!
Answers (1)
3/31/2025, 11:00:59 PM
OpenHealth AI
It sounds like you have several valid concerns regarding your son's health, particularly with his elevated LDH levels, hemolytic anemia history, and associated symptoms. Understanding these results can be challenging, but I'm here to help clarify things and suggest practical steps moving forward.
Key Points:
- Elevated LDH Levels: This can indicate cell turnover or damage, often seen in hemolysis, but it is not specific to one condition.
- Low Ferritin Levels: This suggests potential iron deficiency, which may need addressing.
- History and Symptoms: His history of hemolytic anemia and current symptoms may point to underlying conditions that need investigation.
Explanation:
- LDH (Lactate Dehydrogenase) is an enzyme found in many tissues and is released into the bloodstream when cells are damaged. In the context of hemolytic anemia, its elevation often reflects increased breakdown of red blood cells.
- Ferritin measures stored iron in the body; a low level might explain symptoms of fatigue or discomfort and could relate to his history of anemia.
- Joint Discomfort and Gastrointestinal Symptoms: These can be associated with various autoimmune conditions or even dietary issues, particularly given the historical context of pancreatic insufficiency.
Next Steps:
-
Address Low Ferritin:
- Consider incorporating iron-rich foods into his diet, like lean meats, beans, lentils, spinach, and fortified cereals. A pediatric multivitamin with iron may also be beneficial, but consult your pediatrician before starting any supplements.
-
Monitor Symptoms:
- Keep a journal noting his joint pain, abdominal discomfort, and any other symptoms, including when they occur and their severity. This information can help identify triggers or patterns.
-
Follow-Up Testing:
- Discuss with his healthcare team the possibility of further tests for autoimmune conditions, given your family history and his symptoms. Tests may include autoantibody panels to check for conditions like lupus or juvenile idiopathic arthritis.
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Dietary Considerations:
- Given past issues with pancreatic insufficiency, consider revisiting diet with a nutritionist. They can help ensure he’s getting adequate nutrition while considering his gastrointestinal symptoms.
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Regular Check-Ups:
- Schedule regular follow-up appointments with his pediatrician and specialists to monitor his lab results and overall health. Due to the complexity of his situation, consistent medical oversight is important.
Reassurance:
It's understandable to feel overwhelmed, especially with a history of health challenges. Remember, you are seeking answers and advocating for your son's health, which is very important. Continuous communication with health providers and monitoring of his symptoms can lead to better management and understanding of his condition. Please don't hesitate to reach out if you have further questions or need additional clarity on specific points.
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