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QUESTION: My 15 month old recently had labs done. Everything was normal except there was low white blood count and low neutrophils. He has been sick with a cold for the past few days so the doctor believes it is just that. I noticed that on his results smudge/basket cells were present. When I search this - all I find is CLL information. What could be the cause of these smudge cells? Should I be worried?

ANSWER: Hi, Amber,

Why did she have the blood done?  Was this routine or was she sick?  How low was the WBC count?  What are the other parameters of the CBC?  If you can give me the answers, I would be happy to give you a well informed answer.  

Smudge cells are commonly seen in normal kids and are rarely a sign leukemia, unless the test is done in a clinical setting where one is suspicious for this.

Good luck, Dr. Olson

---------- FOLLOW-UP ----------

QUESTION: It was just a routine blood test. The white blood count was 4.9, RBC 4.20, Hemoglobin 12.1, Hematocrit 35.6, Platelets 300. He has never had any health problems, normal height and weight, and developmentally advanced. Thank you for your help!

Answer
Hi, Amber,

Most of us as pediatricians get little in the way of complete blood counts, unless one is ill and the results can help us diagnostically or theraputically.  A hemoglobin to check anemia is about all most of us do.  The problem with CBCs is you get a lot of stuff like this that is potentially worrisome, but has no bearing if you are a healthy kid.

Good luck, Dr. Olson

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David Olson, MD

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I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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