<s>[INST] My daughter is four years old and for three weeks has been very pale, lethargic and irritable. A week ago she started having a slight temperature at bedtime, she has had this most nights since. She has had loose stools for about a week, she vomited once during the night last Friday, and now for the last few days she has also had a bad cough and is veery hoarse. I m worried that there might be something serious, such as leukemia, wrong with her. I have taken her to our doctor twice who has both times sent us away saying it is something viral . I just don t understand why she has been so out of sorts for so long. She cries very easily and gets tired out quickly. She does play and tries to do normal things but always becomes upset after an hour at the most, and cries inconsolably. [/INST] Hi, Your child is most probably having chronic diarrhea, which may be non-infective in origin. It may be of some sort of allergic to foods or irritable bowel disease, Crohn's disease. You need to find any correlation with specific food or specific pattern of altered bowel habit like loose motion and constipation. The child should be worked up properly with CBC, ESR, STOOL-R/M AND REDUCING SUBSTANCES, FECAL FAT ESTIMATION AND IF NEEDED SPECIFIC TESTS LIKE IGA, TTG. Whether you are giving any iron supplement or not and have you done deforming, I need to know before your children diagnosis. </s>