#1
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Ýðèòðîöèòîç ó ðåáåíêà
Äîáðûé äåíü, ïðîøó ïðîêîììåíòèðîâàòü àíàëèçû ðåáåíêà. Äåâî÷êà, ðîñò 84 ñì, âåñ 10.5 êã, âîçðàñò 1 ã.10 ìåñ. (ïðè ðîæäåíèè ðîñò 51 ñì, âåñ 3170 ã.)
Àíàëèçû: ýðèòðîöèòû 4.67 10*12/ë (3.97-5.01) ãåìîãëîáèí 137 ã/ë (102-127)+ ãåìàòîêðèò 38.2 % (30.9-37.9)+ ñðåäíèé îáüåì ýðèòðîöèòîâ (ìñv)81.8 ôë (71.3-82.6) ñðåäíåå ñîäåðæàíèå ãåìîãëîáèíà â ýðèòðîöèòå (ìñí)29.3 ïã/êë (23.2-27.5)+ ñðåäíÿÿ êîíöåíòðàöèÿ Íb â ýðèòðîöèòàõ (ìñíñ)35.9 ã/äë (31.-34.2)+ îòí.øèðèíà ðàñïðåä.ýðèòð.ïî îáüåìó (ñò.îòêëîíåíèå)35.8 ôë (34.9-42.4) îòí.øèðèíà ðàñïðåä.ýðèòð.ïî îáüåìó (êîýôô.âàðèàöèè)12.4 % (12.7-15.1)- òðîìáîöèòû 261 10*9/ë (214-459) ñðåäíèé îáüåì òðîìáîöèòîâ (ìðv)10.9 ôë (8.8-10.6)+ òðîìáîêðèò (ðñò)0.29 % (0.18-0.39) îòíîñèòåëüíàÿ øèðèíà ðàñïðåä.òðîìáîöèòîâ ïî îáüåìó (PDW)12.8% (9.9-15.4) ëåéêîöèòû 6.45 10*9/ë (6.48-13.02) ýîçèíîôèëû% 1.4% (0.0-3.2) áàçîôèëû% 0.2% (0.0-0.6) ëèìôîöèòû % 74.9% (27.4-79.9) ìîíîöèòû% 9.3 % (3.8-12.8) íåéòðîôèëû 0.92 10*9/ë (1.27-7.18)- íåéòðîôèëû% 14.2% (16.90-74.00)- ýîçèíîôèëû 0.09 10*9/ë (0.02-0.58) áàçîôèëû 0.01 10*9/ë (0.01-0.06) ìîíîöèòû 0.60 10*9/ë (0.26-1.08) ëèìôîöèòû 4.83 10*9/ë (1.52-8.09) ñîý 2 ìì/÷àñ (0-10) âûïîëíåíî ïî ìåòîäó Âåñòåðãðåíà æåëåçî 12.2 ìêìîëü/ë (9-21.5) ôåððèòèí 13.7 ìêã/ë (6-60) âèòàìèí Â12 930 ïã/ìë (189-833)+ çà 2 ìåñ äî ïðåäñòàâëåííûõ ðåçóëüòàòîâ àíàëèçà æåëåçî 25.5 ìêìîëü/ ë (9-21.5)+ ôåððèòèí 28 ìêã/ë (6-60) òðàíñôåððèí 2.72 ã/ë (2.03-3.60) ýðèòðîïîýòèí 9.69.6 ìÌå/ìë (3.7-31.5) âèòàìèí Â12 1010 ïã/ìë (189-833)+ ôîëèåâàÿ êèñëîòà 17.6 íã/ìë (3.1-20.5) ãåìàòîëîã ñòàâèò äèàãíîç:ýðèòðîöèòîç âòîðè÷íûé, íåéòðîïåíèÿ (âèäñ?) âîëíóþò ïîêàçàòåëè ãåìîãëîáèíà, ãåìàòîêðèòà, ìñí, ìñíñ, ìðv (ýòè ïîêàçàòåëè âûøå íîðì)è ïîêàçàòåëü îòí.øèðèíà ðàñïðåä.ýðèòð. ïî îáüåìó (êîýôô.âàðèàöèè) ÷òî íèæå íîðìû. òàêèå öèôðû ìû íàáëþäàåì îêîëî ãîäà, ñäàåì êðîâü êàæäûå 2-3 ìåñ, âñåãäà óêàçàííûå ïîêàçàòåëè âûøå, à ïîêàçàòåëü îòí.øèðèíû...íèæå íîðì íà áëàíêå ëàáîðàòîðèè (kdllab), ñäàåì âñåãäà â îäíîì ìåñòå, îíëàéí ðåçóëüòàòû âèäíû óæå â ïåðâûå 3-4 ÷àñà ïîñëå çàáîðà êðîâè. ïåðåä ïîñëåäíèì àíàëèçîì(÷òî ïðåäñòàâëåí âûøå), äî÷ü ìèí çà 45 âûïèëà âîäó â îáüåìå 200-230 ìë, êðîâü áûñòðî ïîñòóïàëà â ïðîáèðêó. íåéòðîïåíèÿ òàêæå íàáëþäàåì ìåñÿöåâ ñ 6. òàêæå íå ïîíÿòíî ÷òî äåëàòü ñ æåëåçîì. íà äàííûé ìîìåíò íàçíà÷åíèÿ âðà÷à ãåìàòîëîãà: êîíñóëüòàöèÿ èììóíîëîãà, ïîëèâèòàìèíû ñ ì/ýëåìåíòàìè+ïèòüåâîé ðåæèì ìèí.350-400 ìë âîäû. î÷åíü õîòåëîñü áû óçíàòü âàøå ìíåíèå ïî ïîâîäó àíàëèçà â öåëîì è êóäà íàì äâèãàòüñÿ äàëüøå!çàðàíåå áëàãîäàðþ |
#2
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Ó ðåáåíêà íîðì. ïîêàçàòåëè êðîâè äëÿ 2 ëåò, ôåððèòèí ìåíåå 18 óêàçûâàåò íà ëàòåíòí. äåôèöèò æåëåçà
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#3
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Ýðèòðîöèòîç ó ðåáåíêà
Ñïàñèáî çà ñêîðûé îòâåò. Ïðîøó åùå ïîìî÷ü, êàêèå âèòàìèíû äëÿ âîçðàñòà 2 ëåò ìîæíî â äàííîì ñëó÷àå ïðèíèìàòü?Äî÷ü àëëåðãèê, èñêëþ÷åíû òàêèå ïðîäóêòû êàê ìîëîêî, ÿéöà, ðûáà, öèòðóñîâûå, ìåä, îðåõè, ôðóêòû/îâîùè ÿðêîãî îêðàñà (ñ îñòîðîæíîñòüþ). èç ìÿñíîãî óïîòðåáëÿåò êðîëèê è èíäåéêà, êèñëîìîëî÷êà (êåôèð)êàæäûé äåíü. Âèòàìèííûõ êîìïëåêñîâ óéìà, íî ñ àëëåðãèåé , êî âñåìó îòíîñèìñÿ ñ îñòîðîæíîñòüþ. Ãåìàòîëîã ïåðå÷èñëèë ñàìûå ðàñïðîñòðàíåííûå âèòàìèíû, ïðî÷èòàâ èíôîðìàöèþ î íèõ, ïðèøëà ïîêà ê “àëôàâèò íàø ìàëûø”, íî âîçìîæíî ýòî ñîâñåì ìèìî. áëàãîäàðþ çà ëþáóþ ïîìîùü!
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#4
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ìîæíî ïðèîáðåñòè æåëåçà áèñãëèöèíàò â êàïñóëàõ 18-25 ìã è ïîäñûïàòü â åäó ïî ïîëîâèíêå, â ïîëèâèòàìèíàõ äëÿ äåòåé êàê ïðàâèëî æåëåçà ìèçåð 1-4 ìã, ÷òî íåäîñòàòî÷íî äëÿ êîððåêöèè ÆÄ
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#5
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Ýðèòðîöèòîç, ïîâûøåíèå Â12
Äîáðûé äåíü. Åùå ðàç ïðîøó ïðîêîììåíòèðîâàòü àíàëèçû ðåáåíêà. Äåâî÷êà 2 ãîäà, ðîñò 86 ñì, âåñ 11 êã. (àíàëèçû îò 03.06.2018)
ýðèòðîöèòû 4.78 10*12/ë (3.84-4.92) ãåìîãëîáèí 139 ã/ë (102-127)+ ãåìàòîêðèò 39.1 % (31.2-37.8)+ ñðåäíèé îáüåì ýðèòðîöèòîâ (ìñv)81.8 ôë (71.3-82.6) ñðåäíåå ñîäåðæàíèå ãåìîãëîáèíà â ýðèòðîöèòå (ìñí)29.1 ïã/êë (23.7-28.6)+ ñðåäíÿÿ êîíöåíòðàöèÿ Íb â ýðèòðîöèòàõ (ìñíñ)35.5 ã/äë (31.8-34.6)+ îòí.øèðèíà ðàñïðåä.ýðèòð.ïî îáüåìó (ñò.îòêëîíåíèå)35.6 ôë (34.9-42.0) îòí.øèðèíà ðàñïðåä.ýðèòð.ïî îáüåìó (êîýôô.âàðèàöèè)12.3 % (12.4-14.9)- òðîìáîöèòû 241 10*9/ë (189-394) ñðåäíèé îáüåì òðîìáîöèòîâ (ìðv)11.3 ôë (8.9-11.0)+ òðîìáîêðèò (ðñò)0.27 % (0.18-0.39) îòíîñèòåëüíàÿ øèðèíà ðàñïðåä.òðîìáîöèòîâ ïî îáüåìó (PDW)13.2% (9.9-15.4) ëåéêîöèòû 5.46 10*9/ë (4.86-13.18) ýîçèíîôèëû% 0.7% (0.0-3.3) áàçîôèëû% 0.2% (0.0-0.6) ëèìôîöèòû % 67.9% (18.1-68.6) ìîíîöèòû% 9.2 % (4.1-11.4) íåéòðîôèëû 1.20 10*9/ë (1.6-8.29)- íåéòðîôèëû% 22.0% (22.40-69.00)- èç 22% íåéòðîôèëîâ 1% ïàëî÷êîÿäåðíûå, 21% ñåãìåíòîÿäåðíûå ýîçèíîôèëû 0.04 10*9/ë (0.03-0.46) áàçîôèëû 0.01 10*9/ë (0.01-0.06) ìîíîöèòû 0.50 10*9/ë (0.24-0.92) ëèìôîöèòû 3.71 10*9/ë (1.25-5.77) ñîý 2 ìì/÷àñ (0-10) ðåòèêóëîöèòû 54.5 10*9/ë (16.40-77.60) íåçðåëûå ðåòèêóëîöèòû % 3.3% (3.0-15.9) âûïîëíåíî ïî ìåòîäó Âåñòåðãðåíà Ðåòèêóëîöèòû % 1.1% (0.4-1) æåëåçî 29.9 ìêìîëü/ë (9-21.5) ôåððèòèí 34.9 ìêã/ë (6-60) âèòàìèí Â12 1238 ïã/ìë (189-833)+ ôîëèåâàÿ êèñëîòà 14.8 íã/ìë (3.1-20.5) ÀËÒ 22 Å/ë (0-35) ÀÑÒ 45 Å/ë (0-51) Ùåëî÷íàÿ ôîñôàòàçà 159 ÌÅ/ë (108-317) Òàììà-ÃÒ 10 Å/ë (4-22) Áèëèðóáèí îáùèé 7.6 ìêìîëü/ë (3.40-20) Áèëèðóáèí ïðÿìîé 1.5 ìêìîëü/ë (0-3.4) Êðåàòèíêèíàçà 101 ÌÅ/ë (0-145) Êðåàòèíêèíàçà-Ì 23.1 Å/ë (0-24) Ãåìàòîëîã ñòàâèò äèàãíîç ýðèòðîöèòîç âòîðè÷íûé, íåéòðîïåíèÿ. Ðåêîìåíäàöèè: íàáëþäàòü â äèíàìèêå çà ïîêàçàòåëÿìè, êîòîðûå âûøå íîðìû. Íàáëþäåíèå ó îíêîëîãà è èììóíîëîãà. Âîëíóåò èìåííî âèòàìèí Â12. Ìû åãî ñäàåì ñ äåêàáðÿ ìåñÿöà 2017 ãîäà. Íà îñíîâàíèè ýòîãî íàñ ñ ðåáåíêîì îòïðàâëÿþò íà êîíñóëüòàöèþ è íàáëþäåíèå ó îíêîëîãà. Ê îíêîëîãó åùå íå õîäèëè.  ñîîáùåíèè îò 26.03.2018 ã. óêàçàíû çíà÷åíèÿ Â12 (930 ïã/ìë) è îáùèé àíàëèç çà ìàðò ìåñÿö.  äåêàáðå 2017 ãîäà àíàëèç ïîêàçàë: Æåëåçî 25.5 êììîëü/ë (9-21.5) ôåððèòèí 28 ìêã/ë (6-60) òðàíñôåððèòèí 2.72 ã/ë (2.03-3.60) âèòàìèí Â12 1010 ïã/ìë (189-833) ôîëèåâàÿ êèñëîòà 17.6 íã/ìë (3.1-20.5) ýðèòðîïîýòèí 9.6 ìÌÅ/ìë (3.7-31.5) Ìîëî÷íàÿ êèñëîòà (ëàêòàò) 1.1 ììîëü/ë (0.5-2.2) ýðèòðîöèòû 4.93 10*12/ë (3.97-5.01) ãåìîãëîáèí 141 ã/ë (102-127)+ ãåìàòîêðèò 39.7 % (30.9-37.9)+ ñðåäíèé îáüåì ýðèòðîöèòîâ (ìñv)80.5 ôë (71.3-82.6) ñðåäíåå ñîäåðæàíèå ãåìîãëîáèíà â ýðèòðîöèòå (ìñí)28.6 ïã/êë (23.2-27.5)+ ñðåäíÿÿ êîíöåíòðàöèÿ Íb â ýðèòðîöèòàõ (ìñíñ)35.5 ã/äë (31.-34.2)+ îòí.øèðèíà ðàñïðåä.ýðèòð.ïî îáüåìó (ñò.îòêëîíåíèå)34.6 ôë (34.9-42.4)- îòí.øèðèíà ðàñïðåä.ýðèòð.ïî îáüåìó (êîýôô.âàðèàöèè)12.2 % (12.7-15.1)- òðîìáîöèòû 294 10*9/ë (214-459) ñðåäíèé îáüåì òðîìáîöèòîâ (ìðv)10.3 ôë (8.8-10.6)+ òðîìáîêðèò (ðñò)0.30 % (0.18-0.39) îòíîñèòåëüíàÿ øèðèíà ðàñïðåä.òðîìáîöèòîâ ïî îáüåìó (PDW)12.3% (9.9-15.4) ëåéêîöèòû 6.85 10*9/ë (6.48-13.02) ýîçèíîôèëû% 0.9% (0.0-3.2) áàçîôèëû% 0.3% (0.0-0.6) ëèìôîöèòû % 70.7% (27.4-79.9) ìîíîöèòû% 9.6 % (3.8-12.8) íåéòðîôèëû 1.27 10*9/ë (1.27-7.18) íåéòðîôèëû% 18.5% (16.90-74.00) èç 18.5 % íåéòðîôèëîâ 1% ïàëî÷êîÿäåðíûå, 17.5% ñåãìåíòîÿäåðíûå ýîçèíîôèëû 0.06 10*9/ë (0.02-0.58) áàçîôèëû 0.02 10*9/ë (0.01-0.06) ìîíîöèòû 0.60 10*9/ë (0.26-1.08) ëèìôîöèòû 4.84 10*9/ë (1.52-8.09) ðåòèêóëîöèòû 65.6 10*9/ë (16.40-77.60) íåçðåëûå ðåòèêóëîöèòû 3.6 % (3-15.9) ñîý 2 ìì/÷àñ (0-10) âûïîëíåíî ïî ìåòîäó Âåñòåðãðåíà Õîòåëîñü äî ïîõîäà ê îíêîëîãó ïîíÿòü ê ÷åìó íàì ãîòîâèòüñÿ ñ ýòèì âèòàìèíîì Â12. Âîçìîæíî íå â ýòó òåìó íóæíî áûëî ïèñàòü.  ëþáîì ñëó÷àå áóäó î÷åíü áëàãîäàðíà çà ëþáûå ðåêîìåíäàöèè. Çàðàíåå ñïàñèáî! |
#6
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íåò íèêàêîãî åðèòðîöèòîçà, â12 èç-çà åãî ïîïàäàíèÿ ñ åäîé èëè ïðîäóêòàìè, ïîñåøåíèå îíêîëîãà òàêæå íóæíî, êàê è ïðîêòîëîãà/ãèíåêîëîãà; íàéäèòå âìåíÿåìîãî ïåäèàòðà è ïåðåñòàíüòå òàñêàòü ðåáåíêà ïî äèëåòàíòàì, íîðìà ãåìîãëîáèíà 2 – 6 = 11.5–15.5 ã/äë; îñòàëüíîå ïî ññûëêå, ðàñïå÷àòàéòå è çàíåñèòå ñâîåìó ãåìàòîëîãó, à òî òàê è ïîìðåò íåó÷åì
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#7
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Ñïàñèáî áîëüøîå çà îòâåò! Åùå ìîæíî âîïðîñ ïðî ìîíîöèòû? Ïîñëå äâóõ ëåò íîðìà 3-6%. Ó äî÷åðè â ïîñëåäíåì àíàëèçå 9,2%, ÷òî óêëàäûâàåòñÿ â íîðìû ëàáîðàòîðèè. Êàê â ýòîì ñëó÷àå îðèåíòèðîâàòüñÿ? È åùå âîïðîñ ïî ïîâîäó æåëåçà.  äåêàáðå çíà÷åíèå 25,5 ìêìîëü/ë, â ìàðòå 12,2 è â èþíå 29,9 ìêìîëü/ë. Ñ ÷åì ìîãóò áûòü ñâÿçàíû òàêèå ñêà÷êè? Çàðàíåå ñïàñèáî!
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#8
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ìîíîöèòû ïî àáñ. öèôðàì = 0.06 õ 15 áóäåò 0.9 ó ðåáåíêà àáñ 0.6
"ñêà÷êè" æåëåçà òîæå ñâÿçàíû ñ êîëè÷åñòâîì æåëåçà â ïèòàíèè èëè äîáàâêàõ, Âû æå íå çàäàåòåñü âîïðîñîì îò÷åãî áîëèò ãîëîâà ïðè íàñòóïàíèè íà ãðàáëè? íå äåëàéòå íå íóæíûõ àíàëèçîâ - íå áóäåò âîïðîñîâ
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |