We decided to bring her into Dr Jim's office, and they were worried about the array of symptoms. They ran labwork and ordered antibiotics, and directed us to start nebulizer treatments to try to improve her respiratory status.
When the labs came back, we learned that Maisie was extremely anemic. These results were so concerning that Maisie was scheduled for an emergent appointment with an Oncologist at the Center for Childhood Cancers and Blood Disorders at Children's Hospital.
At the appointment, more labs were drawn and the Oncologist personally evaluated the smears to determine what might be the cause of Maisie's anemia. Luckily her physical exam was unremarkable with the exception of a fever and pallor. The Oncologist strongly felt that a condition called transient erythroblastopenia of childhood or TEC was the cause. TEC occurs after a virus or illness and affects the bone marrow's ability to create red blood cells. It is normally a temporary disorder that only affects children, with the anemia lasting between 1-8 months typically. There is no treatment if the child's reticulocyte count shows recovery, as Maisie's does.
We will follow up in a few weeks to make sure that Maisie's red cells are recovering from the TEC. As of now, Maisie is feeling better, regaining strength and color, and needing less oxygen support at night. Hopefully this is just a one-time bump in the road for sweet Maisie. She handled everything extremely well, but definitely does not like getting "poked".