My daughter is 9 with a history of itp. what would cause high wbc 21.80, low lymphocytes 3, high absolute# segs 20.3 and high neutrophil % 93?

Neutrophilia: The percentages are of no concern; only the absolute counts matter. Your daughter's high white counts represent a significant infection or myeloproliferative disease until proved otherwise, though i can raise my neutrophil count to this level doing a cold-water swim. Your daughter's physicians know what to do and will keep you informed.

Bacterial infection: Leukocytosis (high white cell count) with shift to left (high neutrophil) suggests bacterial infection.