Dr. Faisal Abdul Karim Malim
Pediatrics
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 7-year-old son has lymph nodes behind his left ear and groin area. Since four years of age, lymph nodes have been present in the right neck and groin area. His general practitioner has requested a blood test, and we have the results in hand. Blood test results show low ferritin levels and other negative results. I hope you will be able to help us.
Hello,
Welcome to icliniq.com.
I can understand your concern. However, please note that such lymph nodes occasionally enlarge during viral or bacterial illnesses in children below eight years. These grow smaller on their own after the disease subsides. Do not worry. These lymph nodes are only of concern if they are very large (more than 2 cm), oozing pus, or joined with each other. Also, I have gone through the reports (attachment removed to protect the patient’s identity), and nothing seems alarming. So the ferritin levels must be low due to low hemoglobin levels (I am sorry, but I could not find hemoglobin levels mentioned anywhere in the reports).
Patient's Query
Hello doctor,
Thank you for the response.
The hemoglobin level is 89 g/L. We have attached three pages of blood reports that have a lot of results in red. Can you please confirm that you have checked everything? Based on the results, is there anything to indicate leukemia or lymphoma? Do we need a biopsy? The lymph nodes on the neck have been there for the past four years and have shown no change. Thank you.
Hello,
Welcome back to icliniq.com.
A hemoglobin level of 89 g/L explains the low ferritin. Yes, I have gone through all your reports, including TSH (thyroid-stimulating hormone), triglycerides (reading is high but acceptable for age), CBC (complete blood count), urea, etcetera in all three reports. As I said, if the nodes are less than 2 cm, not joined to each other, there is no discharge, and the child is growing well, you need not do anything.
Patient's Query
Hello doctor,
Thank you for the response.
Can you please check these two attachments? I missed them earlier. We are a bit concerned about the creatine level, especially.
Hello,
Welcome back to icliniq.com.
Yes, these reports (attachment removed to protect the patient’s identity) are acceptable for a growing child of this age. Do not worry. The creatine levels are below normal.
Patient's Query
Hello doctor,
Thank you for the response.
I am just worried because my family has a history of kidney problems. Is it normal for the lymph nodes on the neck to stay for that long, and could it have spread to the groin area, as we only discovered the lymph nodes in his groin three weeks ago? Do you think there might be an infection causing this? My son has no symptoms, and he is very active.
Hello,
Welcome back to icliniq.com.
Yes, it is quite possible for lymph nodes to grow big and then small depending on the onset and resolution of infection. However, they should not have the characteristics I mentioned earlier. With regard to the renal issues, there is no such anomaly currently visible based on the reports sent by you.
Patient's Query
Hello doctor,
Thank you for the response.
With the very low iron, does this classify as anemia? If yes, how severe is it as per his blood results?
Hello,
Welcome back to icliniq.com.
Yes, this is anemia (moderate category).
Patient's Query
Hello doctor,
Thank you for the response.
He does not have any symptoms. Is it normal?
We only picked up on his blood test. We have been prescribed iron tablets. Should this regulate the problem?
Hello,
Welcome back to icliniq.com.
Yes, please continue the iron tablets as prescribed. This should take care of the hemoglobin levels in two to three months.
Patient's Query
Hello doctor,
Thank you very much for your help.
Hello,
Welcome back to icliniq.com.
No problem. It is my pleasure.
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Pediatrics
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