My nephew

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Offline Manal

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My nephew
« on: October 21, 2007, 12:23:14 AM »
Hi

We did some blood tests to my nephew who is a baby (13 months) and they were as follows:
HB 11.5 ( 10- 12.5)
Ferritin 15 ( 18 - 300s)
Hb A2   6.5%
Hb A1   93.5% ( 97-99)
Hb F      0%
hb S      0%
MCV      67  ( 74-90s)
TIBC normal

*Do these results indicate that he is a minor??
*I know that when the ferritin is low, usually the Hb A 2 is not accurate. Does this apply here??
*Why the decrease in ferritin is not reflected on the Hb level ?
* Are there cases in thal minor, where iron deficency animia is always constant (chronic) no matter iron supplements you take??
* What is exactly HB A2 function, why it is always an indicater of thal ( i mean we all know why HB F is an indicater, but why Hb A2 gets elevated too , is it useful ?)

Again too much questions :crazy :winky

Manal


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Offline Andy Battaglia

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Re: My nephew
« Reply #1 on: October 21, 2007, 07:07:51 AM »
The higher HbA2 level does indicate thalassemia trait (although this can also indicate sickle cell, but family history rules that out in this case, I believe). So yes, most likely thal minor with the low MCV also an indicator.

The ferritin reading can vary from test to test, so I would suggest another test after some months to see if this is constant. Iron fortified cereals are often used at this age and are probably a good idea right now. Iron deficiency anemia is not necessarily a lifetime condition, so further tests would be required after some attempt to raise iron levels with diet and possibly supplements if other tests indicate a serious iron deficiency (doubtful because of the fairly normal Hb level). The low ferritin being accompanied by a normal Hb most likely means that tissue iron is at the least, close to normal.

I know Marientina has an ongoing battle with iron deficiency so yes, it can be a long term problem in minors, but at this age and with the normal Hb, there is nothing to indicate that iron deficiency anemia will be a major problem here.

HbA2 is one of the normal hemoglobins and it does carry oxygen, but its levels are usually not significant. It consists of two alpha chains and two delta chains. An HbA2 of 6.5% in a patient with an Hb of 11.5 means that only .75 grams/dl is HbA2. Hardly enough to make a large difference. It is higher in thal because there are more alpha chains than beta chains, and they can combine with the small amount of delta chains available, causing a higher percentage of HbA2 among thal carriers.
Andy

All we are saying is give thals a chance.

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Offline Zaini

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Re: My nephew
« Reply #2 on: October 21, 2007, 08:34:42 AM »
Hi,

I also have a question,if a thal minor's ferritin is in normal ranges,but hb is low,what does it indicate,and what would be the steps to be taken,as iron supplements to raise hb are ruled out in this condition,and i think one can't start a high iron diet with normal ferritin levels,then what could be done to raise hb level?

ZAINI.
^*^Xaini^*^

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Offline Manal

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Re: My nephew
« Reply #3 on: October 21, 2007, 11:24:03 AM »
Thank you Andy so much :hugfriend, but what do you mean by iron tissue?


Zaini, in this case as Andy said once, the following is recommended: folic acid, vitamin E and any of the natural hb inducers that gives enrgy like wheat grass, aloe vera or carao

Manal

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Offline Andy Battaglia

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Re: My nephew
« Reply #4 on: October 21, 2007, 03:31:43 PM »
Tissue iron refers to the body tissue iron that is normally stored in the body.
Andy

All we are saying is give thals a chance.

 

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