Laboratory Data

1. CBC with differential. Look for signs of chronic anemia or acute blood loss. Is WBC count elevated? Eosinophilia suggests parasites or allergy.

2. Coagulation studies (PT, PTT, platelets, bleeding time). Coagulation problems are uncommon in children but need to be ruled out.

3. Urinalysis, BUN, creatinine. Evaluate for pulmonary-renal syndromes.

4. ABGs. Evaluate for impending respiratory failure.

5. Sputum. Obtain for bacterial, mycobacterial, and fungal cultures; cytology.

6. Other workup. Consider IgE level (ABPA, allergies, parasitic infection), hemosiderin-laden macrophages (alveolar hemorrhage syndromes), milk precipitins (Heiner syndrome), antiglomerular basement membrane antibodies (Goodpasture syndrome), ANCAs (Wegener granulomatosis).

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