NRBCs in bloodwork

[kaakla]

Hi, I have a question about some bloodwork my one year old recently had done. She is 14 months old and overall in great health...never really been sick, normal growth/development, etc. I noticed she had a slightly swollen lymph node on one side of her neck (maybe the size of a kidney bean) and took her to her dr who said most likely nothing but wanted to do a blood draw to be safe. He said a couple things were a little outside normal range, but wasn't too concerned and wanted to repeat blood in one month. The NRBC # isn't 0, which everything says is cancer or something else equally terrifying. She has no symptoms other than the slightly swollen lymph node. I don't want to jump to worst case scenario, but obviously can't help but panic thinking about my baby being sick. Any insight would be great.

Normal range is listed first, followed by her number.
NEUTROPHILS %, AUTOMATED COUNT 25.0 - 46.0 %    24.8
LYMPHOCYTES %, AUTOMATED COUNT 50.0 - 77.0 %  62.6
MONOS %, AUTO 1.0 - 12.0 %   9.0
EOSINOPHILS %, AUTOMATED COUNT 0.0 - 10.0 %   2.9
BASOPHILS %, AUTOMATED COUNT 0.0 - 1.0 %  0.7
RBC NUCLEATED AUTO COUNT, BLD <=0.0 %  0.1
NEUTROPHILS, ABSOLUTE, AUTOMATED COUNT 1.5 - 8.5 x1000/mcL   2.3
LYMPHOCYTES, AUTOMATED COUNT 1.2 - 3.4 x1000/mcL   5.8
MONOCYTES, AUTOMATED COUNT 0.1 - 1.0 x1000/mcL   0.8
EOSINOPHILS, AUTOMATED COUNT 0.0 - 0.7 x1000/mcL   0.3
BASOPHILS, AUTOMATED COUNT 0.0 - 0.2 x1000/mcL   0.1

WBC'S AUTO 6.0 - 17.5 x1000/mcL 9.3
RBC, AUTO 3.70 - 5.30 Mill/mcL 4.51
HGB 10.5 - 14.5 g/dL 12.4
HCT, AUTO 33.0 - 38.0 % 35.3
MCV 70.0 - 86.0 fL 78.3
MCH 23.0 - 31.0 pg/cell 27.5
MCHC 30.0 - 36.0 g/dL 35.0
RDW, BLOOD 11.5 - 14.5 % 12.3
PLATELETS, AUTOMATED COUNT 130 - 400 x1000/mcL 388

Thanks so much.

[Ken_PA]

Also, that cite says "they  cannot  consistently  detect  <5%  NRBCs", so even if a followup CBC says there are zero, that cannot be relied upon. That's more reason for doing a smear.

However, that article is from 2000 and very possibly machines are better now.

[Ken_PA]

Hi, the first thing I'd wonder is if an automated count for NRBCs is considered to be reliable. You might ask for a blood smear, rather than waiting in worry for a month.

http://labmed.ascpjournals.org/content/31/4/223.full.pdf
"Nucleated RBCs—Significance in the Peripheral Blood Film"

says "samples  with  flags  should  be  microscopically  examined"

Also note that "systemic infection" is mentioned.