<s>[INST] My 5 years old daughter s WBC count is 16.4 K/uL and LDH is 543 u/I. Her WBC was in this range since April 2010. But her blood picture doesn t show any abnormal cells. Her NAP score is normal. She is active and doesn t loose any weight. Infact she has gained weight. She has a skin rash in her buttocks and time to time she complains that stomach is paining ( above the belly button and upper left hand corner of the belly button). Still her dr is investigating on the matter. What could be the reason for these symptom. [/INST] Hi, Is the skin rash color red? Any tests have been done for platelets and hemoglobin? Elevated LDH means a lot of things. It could be hemolytic anemia, spherocytosis or all malignancy myelofibrosis. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician </s>