my son has the big T..

Andy,

at last the result of electroporesis is out
Interpretation:
 No abnormal hemoglobin is detected. Hemoglobin F (1.5%) is accetable for age. Hemoglobin A (95.8) and Hemoglobin A (95.8) and Hemoglobin A2 (2.7%) are present. Review of smears shows significant microcytosis. If iron deficiency is excluded, consider thalassemia trait.
                             RESULT              UNITS                             NORMAL VALUES
WBC Count           13.81              10^3/ul                    4.5- 11 10^3/ul
    Neutrophil         27.7                     %                        50-70 %
     Lymphocytes      62.7                    %                        20-40%
     Monocytes         7.5                       %                        2-8  %
     Eosinophils           2                        %                        2-8 %
      Basophils            .1                         %                       0-1%
RBC COUNT              6.63                  X10^6/UL             4.6 - 6.2 X 10^6/UL
HGB                         12.2                 g/dl                       13.5-18 g/dl
HCT                          36-6               %                           40-54%
MCV                        55.2           FL                               80-100FL
MCH                        18.4                    PG                              27-32PG
MCHC                        33.3                  g/dl                             31-35 g/dl
RDW                         20.1                  %                               11.6-13.7 %
PLATELET               454                             X10^3/UL              150-400 X 10^3/U


Remarks:
Presence of microcytic RBC


Please enlighten me..Is this dangerous.What is the meaning of this..

Thank you and I'll be waiting

Hi Mommyjanice,

I've been out and was just able to see your post. It is very late at night here, so I will have to come back with more explanation, but I want to tell you that there is nothing at all here that should be considered dangerous. If thalassemia is involved, it is carrier status and not an intermedia status like HbH disease. It may be compounded with iron deficiency, or even simply iron and or folate deficiency.

I will be back with a further explanation but it is after 3 am here, so I will sleep.

As I mentioned earlier, there is no dangerous situation here and you can relax a bit. As I had also mentioned in the previous post, these readings can vary from test to test and we see that with this latest test. The Hb level is 2 points higher than in the previous test. This alone will rule out HbH disease (3-gene deleted alpha thalassemia). The RDW in the new test is considerably higher, and again this is why when tests are borderline, they must be repeated. An RDW this high is only seen in iron deficiency. Once it passes 18.9, alpha thal is ruled out. The HbF of 1.5% is slightly high, leading to the possibility of beta thal minor. However, the HbA2 is normally a bit higher in beta minor, except when iron deficiency is also present. Microcytosis would be present in both iron deficiency and beta minor. So, this may be a case of just iron deficiency or iron deficiency in a thal minor. The rise in Hb since the previous test could be the result of the iron therapy, or the previous test may have been done when the child was sick and the Hb had dropped. The key statement made in this report is "If iron deficiency is excluded, consider thalassemia trait."

My advice is to request a panel of tests called iron studies to determine the true iron status. Ask the hematologist to run these blood tests, as the possibility of thal minor being concurrent muddies the picture some, and you also need to know if progress has been made correcting the iron level. I would also suggest paying special attention to his diet and make sure that it is thoroughly nutritious and does not contain any empty calories like junk foods. A daily child's multivitamin is appropriate, also. Citrus fruit and juices are recommended for the vitamin C content, as this will aid in iron absorption.

I will be very interested in what the hematologist has to say. I do not think there is a serious problem here, and most likely things can be corrected with proper nutrition. It is important to get an answer of whether or not he is a thal minor, as this is extremely important later in life when he decides to have children. All minors need to make sure their partners have been tested for carrier status, as two carriers can produce a major and this is very serious and should be avoided if possible.

Oh Andy, your ord seems eases the burden in my heart..Now I can breath..

Thank you for giving me these information eventhough we don't personnally each other..
I honestly appreciate your kindness. We owe a lot to you..

Tomorrow, we will be seing the Hematologists..
I'm now equipped with information so that i will thoroughly understand the explanation of our doctor..

I will post immediately the result..

Once more, Thank you very much...

hi Andy,

I have been very busy these past few days that's why I forgot to post here..

My son was diagnosed to have Thalassemia trait..

The hema also instructed us (me & my husband) to undergo CBC..

Guess what, I'm the carrier..

Just this morning,  I attended the annual conference for Thalassemia patient here in Metro Manila, Phils.

Unluckily, I left my son at home. They are conducting free serum ferritin test. .

on our next visit, he will undergo iron ferritin test to know if the iron supplements he took for 7 months have somehow store in his body.

I'm aslo informed that iron chelation drugs here in the Philippines are very expensive. Unlike in other countries that the government is giving it for free.

Thanks Andy for the helped....for the infos and knowledge...

Hi mommyjanice,

I would actually be more concerned that he is still iron deficient rather than iron loaded. As I mentioned in my previous post, his test values show the possibility of iron anemia. Of course, the values have varied quite a bit from test to test, so test error is also a possibility. In addition, 7 months of iron should not be long enough to raise the iron load to a dangerous level. If there is a high ferritin level (I would be very surprised if this is so), it won't take much effort to lower it and chelation would not be needed.

You may want to read up on beta thal minor in our boards and also about nutrition, as some minors will have symptoms and optimizing the health and immune system are important.

I hope you can rest easy now. There is absolutely no serious problem. One main thing to remember is that he should always be aware of his status so he can take precautions when he is an adult and it is time to have children of his own.