Is my baby beta thal minor?

Dear specialist here,

My baby boy (Birthday: Sep. 13, 2008) was detected as IDA in May and then took iron and multivitamin drops. His is very active and developing very well.
Last week he had a follow-up check with Hb electrophoresis and the Dr told us my baby is beta Thal trait. We are so worry about it and seek for further help.

Thanks a lot!!!!

ilovemybaby

Hello,

Welcome on the forum,I have a few questions,is this baby boy your first baby? Have you ever tested your self for thal,were you or your partner declared anemic at any stage in your life?

Thalassemia is a genetic disorder,your son is just carrying a trait or in other words he is a thal minor,but he has inherited this disorder from you or your partner,what is crucial here is that you and your partner get tested for thalassemia,because if you both are carriers,and if you plan another baby in future,there is a 25% chance that baby can be thal major,and if one of you is carrier,then it would be good to know so that you can be treated accordingly in future.

Thal minor is not a very dangerous thing,your baby will lead a normal life,i am a thal minor my self and a mother of two i occasionally experience tiredness or headaches,my hb remains low,but there are so many supplements which can help thal minor now a days,so just try to read through our thal minor section and you'll get the idea what would help your baby and what can be harmful.

If you have other kids,get them tested too,even if a person is just a carrier its good to know,so when they grow up and plan a family,they must know that if their partner is a carrier or not.

Hope this helps,please feel free to ask what ever questions you have in mind .

Zaini.

Deai Zaini,

Thanks for your prompt reply.
This is our first baby. We did not do a specific test for thal and no hints show us anemia. My uncle (my father's younger brother) has aplastic anemia and he is around 60 years old now.

Just want to know, are the lab results confirming my baby thal trait or further test is needed?

Thanks,

Hi ilovemybaby,

The first test results actually looked liked intermedia but the test from July 3 looks like it is definitely thal minor. The Hb level rose to minor range and the MCV is also higher. The HbA2 and HbF both indicate thal minor. Iron supplements will not have a positive effect and if taken long term when not needed, can cause damage to the organs. It will be much better to supplement with folic acid and B vitamins. I don't think any other testing is required but if any question still persists or if you want to identify the exact variant gene, a DNA analysis would provide these answers.

Thank you so much, Andy.
But after doing an online research I still have several doubts on the technical details.

The 1st iron studies clearly showed IDA that was confirmed by our paediatrician.
After taking iron and multivitamin drops for one month, his iron level is going to the normal range, Hb level and MCV increase, and PCV is increasing close to the normal range. My questions are:

1, Can Thal intermidia transfer to Minor with proper treatment?
2, Increased Hb level and MCV is due to intake of iron and multivitamin drops?
3, I found RDW is in normal range for Thal and higher than the normal for IDA.
4, I also found that Reti is higher than the normal for Thal, but our baby's value is far lower but not indicated with star in the report.

We make another appointment next week to confirm our couple's situation and ask for advices for our next baby.

Thanks a lot again for your knowledge.

ilovemybaby

Hi ilovemybaby,

The first test results actually looked liked intermedia but the test from July 3 looks like it is definitely thal minor. The Hb level rose to minor range and the MCV is also higher. The HbA2 and HbF both indicate thal minor. Iron supplements will not have a positive effect and if taken long term when not needed, can cause damage to the organs. It will be much better to supplement with folic acid and B vitamins. I don't think any other testing is required but if any question still persists or if you want to identify the exact variant gene, a DNA analysis would provide these answers.

Hi,

I'll try to answer your queries as much as i can,for expert opinion you'll have to wait for Andy's reply .

Thal intermedia can not be transfered to thal minor with any treatment,because its due to the genetic mutation a child is born with,thal intermedias maintain a certain level of hb and they can be given Fetal Hb inducers to try and raise their hb .But no they can not be transfered to thal minor.

In your baby's case as Andy said he is a thal minor,and in his first Iron studies his iron was really really low and that's why he responded to iron suppliments and his hb increased.In his second Iron studies his iron is well with in range,are you still giving him iron suppliments?Did your doc asked you to stop them? Personally i think that he does not need iron supplements any more,but please consult with your doctor about it.Instead i'll prefer giving him a good B Complex daily and keep checking his hb every month,and even in between if he gets sick.

Do you notice that he is not much active when his hb is down or he feels lethargic? There are a couple of supplements i'd like to suggest,Have you heard of wheat grass ? Try either fresh wheat grass juice if you can or there are super shots available online,they might help you raise his hb and if not,you'll still see a definite boost in his energy levels.

There is another natural supplement called carao,,a few members on our forum ,including my daughter tried this and we had positive reults you can read all about this in these threads,

http://www.thalassemiapatientsandfriends.com/index.php?topic=1259.0

http://www.thalassemiapatientsandfriends.com/index.php?topic=1791.0

Hope this helps.

Zaini.

Zaini,

Thanks for your reply.
After the 2nd test, the doctor suggested we reduce the iron intake as half (i.e. 10 drops per day now). But we decide to see another haematological doctor next week to confirm everything.

Our baby is very active since he was born. His development is very well more than 90% or 100%. That was the reason we did not imagine any problems with him.

To perform the first blood test was due to an occasional cause. We found bloody stool one day in May and went to emergency. My baby was checked with blood and stool. We then found IDA but were still not clear for bloody stool.

Even before, we went to see a doctor for a routine development check when our baby was 6 months old and we suggested a blood check for his iron, zinc, calcium levels. The doctor checked our baby and his length, weight, and head circumference were like a one-year-old baby. He was very active then. So the doctor told us no lab test was necessary. But two month later we got to emergency and found IDA.

Thanks,

ilovemybaby

Hi ilovemybaby ,

Was your baby breastfed? This actually makes a big difference in the understanding of low iron levels in the first six months.

What makes me think it is thal minor is the low MCV even after iron supplements and the high HbF and at least normal HbA2, which is normally lower in iron deficiency. The RDW is just slightly above the cut off range of 18 that separates beta thal trait and iron deficiency, so this value only offers some confusion at this point.

Because of the young age, it can be very difficult to diagnose if this is iron deficiency alone or IDA combined with thal trait. You can wait a couple months and have another CBC and hemoglobin electrophoresis done, or you can have a DNA analysis done, which would give you a definite answer.

The main thing to consider is that your child is doing well and growing well, so regardless of what the status is, if it is thal minor, it is not having any effect on development. Most minors don't even know they are minors, so it is really nothing much to worry about even if he is a carrier. The only concern would be later in life when he chooses to have children of his own. If it does prove out that he is a thal trait carrier, his partner should also be tested before having kids.