Pale Child, several abnormal blood test results

Patient

Q: My 6 year old daughter looks pale, her iron tests came back normal, should i be worried? The doctor ran various blood tests on her and the only ones that were off were the following:
reticulocyte count: percent retics was 2.3, normal range 0.5-1.5
retic count was 113, normal range 40-80
RDW was 10.4, normal range 10.5-14.5
Eosin was 5, normal range 0-1
Basophils was 2, normal range 0-1

I thought that her iron levels would be off, but they are completely normal.

Symptoms:  Looks tired, poor appetite
Doctor

A:   Hi welcome to Ask The Doctor,

Paleness, also known as pale complexion or pallor, is an unusual lightness of skin color when compared with your normal hue. Paleness is caused by reduced blood flow or a decreased number of red blood cells. You should see your doctor if you have a sudden onset of generalized paleness or paleness of a limb. Anemia, a condition in which the body doesn’t produce enough red blood cells, is one of the most common causes of paleness. Other causes of paleness include: lack of exposure to sunlight, skin that is naturally pale, cold exposure and frostbite, shock (dangerously low blood pressure), low blood sugar, blockage in the artery of a limb (local paleness).
Symptoms of acute onset anemia include:
rapid heart rate, shortness of breath, high or low blood pressure, loss of consciousness, irregular or absent menstrual period. Call your doctor right away if you suddenly develop generalized pallor.

Paleness accompanied by signs of blood loss such as fainting, vomiting blood, bleeding from the rectum or abdominal pain is considered a medical emergency. Shortness of breath and sudden onset of paleness, pain and coldness of a limb are also serious symptoms that require immediate medical attention. Treatment options include: balanced diet, and iron, B12 or folate supplements blood transfusion may be necessary, surgery is an option for certain causes of acute blood loss, such as trauma. Surgery may also be required for treatment of arterial blockage.

Hope this helps.

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