Q. My 3-year-old daughter has a large lump on her jaw and her ALP level is 2500. Please help.

Answered by
Dr. Sumeet Sharma
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 29, 2021

Hi doctor,

My 3-year-old daughter has recently been in hospital with a large lump on her jaw where her neck meets her ear. She had some blood works done and was treated with IV antibiotics for 24 hours, then given oral antibiotics for seven days. She went for the follow-up to the general physician, who repeated the blood works after seven days and said she had microcytic anemia, iron deficiency anemia.



Welcome to

Neck swelling can be due to parotitis, or it can be lymph node swelling. Iron deficiency anemia is a very common problem in growing infants. The reason is usually nutritional, either decreased oral intake or deceased absorption of iron from the gut. From your query, it was not clear what you want to ask. Kindly specify your question. And please share the detailed investigation reports.

Hi doctor,

I completely understand what you are saying, and decreased absorption is a definite possibility. However, she also has an ALP level of 2500. This is baffling. My doctor thinks this is very suspicious with the large lump, the microcytic anemia, and very high ALP. He just sent me to a specialist, which is some time away. I cannot sleep. They did say she will need a transfusion for iron but. What are the possibilities? Other LFTs are normal and ALP so high, with the microcytic anemia.



Welcome back to

I can understand how you must be feeling. Large lump along with anemia and raised ALP (alkaline phosphatase level) needs a thorough evaluation. Although ALP levels in children are slightly higher than adults, the level of 2500 is quite alarming. With normal liver enzymes, ALP levels can be raised in bone disease or in lymphomas. I would advise you to get that specialist appointment as soon as possible.

I wish her a speedy recovery.

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