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Dr. A. Clark
Dr. A. Clark, Pediatrician
Category: Pediatrics
Satisfied Customers: 4437
Experience:  33 years of experience as a general pediatrician in private practice and in pediatric urgent care.
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If a 1 year old presented with the following out of range

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If a 1 year old presented with the following out of range blood values, what would your likely diagnosis/follow up be?
Carbon Dioxide 19 (norm 20-28)
Globulin 1.7 (norm 2.1-3.9)
ALB/GLOB Ratio 2.6 (norm 1.0-2.0)
Alkaline Phosphatase 401 (norm 124-341)
Bilirubin 0.1 (norm 0.2-1.3)
Dr. A. Clark :

I'm happy that you have asked me to assist you with your child and hope that you can benefit from my many years of helping parents like you.

Dr. A. Clark :

Can you chat right now?

Dr. A. Clark :

You must be away from your computer so let me ask you first, why was the blood count done in th first place?

Customer: It was as part of an evaluation panel for celiacs, which was found to be negative. In addition to the mentioned, she was also found to have Lymphocytes at 66 (norm 40-65) and a Bun/Creatine Ratio of 40 (norm 10-28)
Dr. A. Clark :

These are all really normal, considering his age, and considering that "normals" vary from lab to lab and with age.

Customer: so no concern on any of these for a 1 year old?
Dr. A. Clark :

His chemistries are really normal and numbers below are not significant for the most part.

Customer: it struck me that the entire work up sheet seems to read out of range so I wanted to get a second opinion
Dr. A. Clark :

I would not give those numbers another thought if I were his doctor and would have done a better job of explaining the variations of normal to you!

Dr. A. Clark :

They only significant if very elevated and the ratios are off only because his BUN was probably 10 or less and his alk phos is normally elevated at his age as a function of bone growth.

Dr. A. Clark :

Again, pediatric normals are quite different and the ranges wider.

Dr. A. Clark :

Than in adults, I mean.

Customer: Thank you for validating that it is not of concern. Have a good night
Dr. A. Clark :

You as well.

Dr. A. Clark :
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