Advice needed for my son.

My son has been diagnosed beta thalassemia minor.  He is adopted and we have no genetic information about either of his biological parents.  In addition, for the first two years of his life, he was in foster care and medical decisions were made by the state, so until recently we have not had much of a say in any treatments, doctor appointments, etc. that he has had. 

My son's most recent labs show:

Hemoglobin      9.3L
Hematocrit       29.2L
MCV                72.9L
MCH                23.2L
MCHC              31.9L
RDW               18.0H
Platelet            703H
Mean Plt Vol     7.2L
Segs               46.0H
Anisocytosis      1+*
Microcytes        2+*
Hypochromasia  SLIGHT*
Polychromasia   SLIGHT*
Target Cells      SLIGHT*

Normal results for: white blood cell count, red blood cell count, various different kinds of white blood cells (lymphocytes, neutrophils, eosinophils, lymphocytes, basophil), Serum Iron, iron binding capacity, Ferritin, Hemoglobin A1C

Immunology - Hemoglobin Electrophoresis
Hemoglobin A      78.4 (Normal 95-98.5)
Hemoglobin S      0 (Normal 0)
Hemoglobin A2    5.7 (Normal 1.8-3.3)
Hemoglobin F      6.2 (Normal 0-2)

Any thoughts on what our next steps should be, now that he's fully adopted and we have control?  I'm going to request labs be re-drawn (these are kind of old), but then I don't know where to go from there.  His ped treats it as a minor thing and doesn't really even push to monitor him or anything.  And I don't really know what he needs.

The only physical symptom we see is increased fatigue (he's an active toddler, but he gets tired more quickly and naps more often than his friends).  He's two years old.

Hi bellamae and welcome,

Your son's tests do indicate thalassemia minor. I do agree a new electrophoresis test should be done, especially since the totals only come out to around 90%.

For the most part, thal minor shouldn't cause him a lot of problems if you pay special attention to diet and nutrition. I would recommend that he take folic acid daily for the rest of his life, as it helps build red blood cells and also extend their life. B-complex, vitamins C, D and E are also very important. A good multi-vitamin without iron should also be taken daily.

The most important issue is that he is always aware that he is a thalassemia carrier and that later in life if he has children with another carrier, there is a chance of having a thal major. He should be made aware that any future partner should be tested for thalassemia.

Hi Bellamae ,
 
  To the Family , please keep in-touch with us and keep posting...


Best Regards
Take Care
Umair