is it normal for RSV infant to have elevated platelet count?

[miniangel729]

I am doing a case study, but there is this one lab value I don't understand.

the patient is a 4 month old female admitted for Bronchiolitis secondary to RSV -2 days ago.

has decrease PO intake for two days prior to admission (about half of what she normally takes).

she has no PMH, born full term, NSVD.

all of her CBC came back normal except her platelet was 522 (normal: 150-450 K/UL).

I checked two different lab value book, the only possible explanation would be maybe "iron deficiency".

but then i went back to my old careplan for the other kid, my instructor made a comment said it was "body's response to prolonged hospitalization"...

I don't understand the rationale behind that, why would platelet go up due prolonged hospitalization/stress response.. (in this case, pt was only hospitalized for 2 day).

Sorry if the question sounds dumb..

but I couldn't find the answer elsewhere..

thanks for helping :)!

[NotReady4PrimeTime, RN]

The clue is in the fact that she's had decreased PO intake for two days. Healthy 4 month olds will usually have relatively normal platelet and white counts and mildly decreased hemoglobin/hematocrit... when they're euvolemic. But cut their fluid intake in half and they're going to be mildly dehydrated. Take a high-normal platelet count and wring off some of the "water" and you'll have an elevated platelet count in no time. And you're right, 2 days is NOT a prolonged hospitalization so that doesn't apply here. Stress hormones do stimulate bone marrow activity somewhat, but in this case, it's more likely hemoconcentration.

[miniangel729]

thank you for the quick and thorough response!

I had thought about dehydration too, but I wasn't sure because none of the other lab values were elevated... but thanks for confirming it :)!