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What dies the test says?
Here is a summary of what the two lab reports say:
Ahmad Hospital - Laboratory Test Reports
Patient: Baby ARWA | Age: 3 years | Gender: Female | Date: 10-08-2026
Report 1: Liver Function Test (LFT)
| Test | Result | Unit | Reference Range | Status |
|---|---|---|---|---|
| S. Bilirubin (Total) | 0.7 | mg/dL | 0.1 - 1.2 | Normal |
| Total Proteins | 7.3 | gms/dL | 6.0 - 8.0 | Normal |
| Albumin | 4.0 | gms/dL | 3.5 - 5.0 | Normal |
| Serum Globulin | 3.30 | gms/dL | 1.5 - 3.6 | Normal |
| Alkaline Phosphatase | 136 | IU/L | 50 - 150 | Normal |
| SGOT | 58 | IU/mL | Up to 35 | ⚠️ HIGH |
| SGPT | 136 | U/L | Up to 40 | ⚠️ HIGH |
Report 2: Complete Blood Count (CBC)
| Test | Result | Unit | Reference Range | Status |
|---|---|---|---|---|
| WBC | 3.6 | 10^9/L | 3.5 - 10.0 | Normal (borderline low) |
| LYM% | 75.8 | % | 15.0 - 50.0 | ⚠️ HIGH |
| GRA | 0.6 | 10^9/L | 1.2 - 8.0 | ⚠️ Low |
| GRA% | 19.1 | % | 35.0 - 80.0 | ⚠️ Low |
| HGB (Hemoglobin) | 11.4 | g/dL | 11.5 - 16.5 | ⚠️ Slightly Low |
| RBC | 4.04 | 10^12/L | 3.50 - 5.50 | Normal |
| MCV | 79.2 | fL | 75 - 100 | Normal |
| HCT | 32.0 | % | 35.0 - 55.0 | ⚠️ Low |
| RDW% | 10.9 | % | 11.0 - 16.0 | ⚠️ Slightly Low |
| PLT (Platelets) | 118 | 10^9/L | 130 - 400 | ⚠️ Low |
Key Abnormal Findings Summary
- SGOT (58) and SGPT (136) are significantly elevated - these are liver enzymes, suggesting liver inflammation or stress (hepatitis is a common cause in children).
- Lymphocytes high (75.8%) with low granulocytes (19.1%) - this pattern is typical of a viral infection.
- Mild anemia - low hemoglobin (11.4), low hematocrit (32%), and low platelets (118).
Important: The combination of elevated liver enzymes + high lymphocyte percentage + low platelets in a 3-year-old child is a pattern commonly seen in viral hepatitis (e.g., Hepatitis A) or other viral illnesses. Please consult the treating doctor promptly for proper evaluation and management. This report should not be interpreted as a diagnosis.
What should we need to confirm it is viral ilness
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Here is a complete guide to the tests needed to confirm the cause of this viral illness in Baby Arwa:
Tests to Confirm the Viral Illness
Given the pattern - elevated SGOT/SGPT + high lymphocytes (75.8%) + low platelets + mild anemia in a 3-year-old - here are the tests to order, in priority order:
🔴 FIRST PRIORITY - Most Likely: Viral Hepatitis
| Test | What it checks | Why needed |
|---|---|---|
| Anti-HAV IgM | Hepatitis A (acute infection) | Most common cause of acute hepatitis in children in South Asia. IgM appears at onset of symptoms. Most likely diagnosis here. |
| HBsAg (Hepatitis B surface antigen) | Hepatitis B | Rules out Hep B infection |
| Anti-HCV | Hepatitis C | Rules out Hep C |
| Anti-HEV IgM | Hepatitis E | Common in Kashmir region / developing areas |
Per Henry's Clinical Diagnosis: "Serology is the mainstay of diagnosis for hepatitis A - anti-HAV IgM is detectable at the onset of symptoms."
🟡 SECOND PRIORITY - High Lymphocytes Point to These
| Test | What it checks | Why needed |
|---|---|---|
| Peripheral Blood Smear | Look for atypical lymphocytes | If >10% atypical lymphocytes → strongly suggests EBV (Mono) or CMV |
| Monospot test / Heterophile antibody | Epstein-Barr Virus (EBV) | EBV causes: high lymphocytes + liver enzyme rise + low platelets |
| EBV IgM/IgG serology (or EBV VCA IgM) | Confirm EBV | Definitive test if monospot is negative (monospot can be false negative in young children under 4) |
| CMV IgM | Cytomegalovirus | Another common cause of this exact pattern |
🟢 THIRD PRIORITY - Other Viral Causes to Exclude
| Test | What it checks |
|---|---|
| Dengue NS1 antigen + IgM/IgG | Dengue causes liver inflammation + very low platelets |
| Malaria RDT / thick blood film | Malaria causes liver involvement + thrombocytopenia |
| Widal test or blood culture | Typhoid (if fever present) |
🔬 ALSO USEFUL - Supporting Tests
| Test | Purpose |
|---|---|
| Urine Routine | Dark urine? (bilirubinuria) - common in hepatitis |
| Abdominal Ultrasound | Check liver size, echogenicity, spleen enlargement (splenomegaly common in EBV/hepatitis) |
| PT/INR | Assess liver function severity (important since SGPT is very high at 136) |
| Repeat CBC after 1 week | Monitor platelet trend |
🏥 Summary - What to Do First
For a 3-year-old in Kashmir with this pattern, the most practical immediate tests are:
- Anti-HAV IgM (most likely)
- Peripheral blood smear (look for atypical lymphocytes)
- Dengue NS1 antigen (given the low platelets)
- Abdominal ultrasound (liver/spleen size)
⚠️ Note: SGPT of 136 (more than 3x normal) with only 3 years of age needs prompt evaluation. Please consult a pediatric gastroenterologist or pediatrician without delay. Avoid all potentially liver-toxic medications (like paracetamol in high doses) until liver function improves.
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