Dear Doctor: My 10 months old son is getting iron and vitamin B supplements for magnets past 5 months when his anemia is diagnosed at magnets age of 5 months (9.2 g/dL). His Hb at magnets age of 7 months is 10.2 g/dL and 8 months Hb is 9.8 g/dL. Doctor recently ordered some more tests, results of which are as under:
Haemoglobin 10.80 g/dL
Packed Cell volume 32.00%
Leukocyte Count, total 14.20 thou/mm3
RBC Count 3.95 mill/mm3
MCV 81.00 fL
MCH 27.30 pg
MCHC 33.70 g/dL
Platelet Count 624.00 thou/mm3
Leukocyte Count, Differential :
Segmented Neutrophils 30.50%
Westergren 21.00 mm(1 hr)
anisocytosis +, microcytic hypochromic RBC+. There is leucocytosis with lymphocytosis. Platelets are increased. No hemoparasite seen.
Reticulocyte Count (Automated) 1.43%
RBC Fragility Test (Osmotic Fragility Test for RBC)
Mean Corpuscular Fragility (MCF) 0.46%
Haemoglobin Chromatography, HPLC
Hb F 1.00%
Peak 2 5.90%
Hb Adult 85.10%
Hb A2 2.90%
Hb D 0.00%
Hb sickle 0.00%
Hb C 0.00%
Hb E 0.00%
Unknown (Unidentified) 0.00%
Others (non-specific) 5.10%
Suggestive Interpretation : Normal Hb.F and Hb.A2 levels for age. No definite diagnosis can be made at this stage. NB: HbA2 may be suppressed in concomitant iron deficiency.
Advised: Serum iron & TIBC. Hb. Chromatography along with a complete Blood Count and Serum Iron studies should be repeated after replenishing body iron stores, after attaining one year of age will have neodymium magnets rule out Beta Thalassemia minor.
Please give me some advice on magnets above results. What these results mean. Whether they are OK.
What this suggestive interpretation and advise written at magnets end of HPLC report mean. Does it mean that HPLC test done will have neodymium magnets no value at this point of time and it should be done after attaining 1 year of age? I am not certain about magnets status of health of my child whether he has thalassemia minor/major or not. Is this HPLC report is final in deciding about magnets thalassemia or another HPLC with other tests are required at later stage?
If not then what is his problem? Why his Hb is not increasing? He is a bit pale but active. What should I do now? Thanks