hello everyone. I m little confused.

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Offline surendra

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hello everyone. I m little confused.
« on: January 23, 2011, 05:46:20 AM »
hi to all. I m new at this forum from maharashtra India. Few months before my daughter was diagnosed as thal major. But Im little confused  just reading some questions and answers at this forum that she is intermedia or major.
 Her foetal Hb was 96.5%.
 Hb on HPLC F+F.
 Hb A2estimation 3.5%
 PCV 14.7%
 Pheripheral blood smear meta+band 4%
 RBC MORPHOLOGY-Microcyctic hypochromic RBC's seen. severe anisopoikilocytosis seen. macrocytes, teardropcells. Target cells polychromatic cells and 200 nRBC's upon 100WBC's.

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Offline Andy Battaglia

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Re: hello everyone. I m little confused.
« Reply #1 on: January 23, 2011, 05:56:06 AM »
Hi Surendra,

At what age was this report done and what was the Hb level at that time?
Andy

All we are saying is give thals a chance.

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Offline surendra

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Re: hello everyone. I m little confused.
« Reply #2 on: January 23, 2011, 06:00:26 AM »
at that time she was six months old.and Hb was 5.6. now she is 11 months old.

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Offline Andy Battaglia

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Re: hello everyone. I m little confused.
« Reply #3 on: January 23, 2011, 06:21:21 AM »
She had no HbA at six months and her fetal hemoglobin was only enough to raise her Hb to over 5. This means she is a beta zero major. At six months, the HbF is usually mostly gone in babies, but in thals it will linger, and still have a sizable effect on Hb. However, this will fade with age in most thals, and is almost never enough to avoid transfusions. An intermedia would show some percentage of HbA and the hemoglobin would be at least 6 without transfusions. Most intermedias do not have to transfuse as early as majors. In some patients, wheatgrass helps increase the Hb level a bit and also has a positive effect on the immune system. Wheatgrass does not taste good, so it may be a problem to give to a baby, unless you can get wheatgrass extract. Folic acid is essential for all thals and she should be taking it daily.
Andy

All we are saying is give thals a chance.

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Offline surendra

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Re: hello everyone. I m little confused.
« Reply #4 on: January 24, 2011, 03:18:28 AM »
So beta zero major need regular transfusion. could u explain what is beta zero major??  Is it differ from beta thal. major? In which form I could give her follic acid.

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Offline Andy Battaglia

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Re: hello everyone. I m little confused.
« Reply #5 on: January 24, 2011, 03:33:52 AM »
Beta zero is thal major. It means that no HbA can be produced. Any natural hemoglobin produced is either HbA2 or HbF. In some beta thal majors, some HbA is produced, but transfusions will still be necessary. Beta zero majors usually have to transfuse fairly early in life, while other majors can wait until later in their first year. There are hundreds of different types of mutations and deletions of the beta globin genes, and when no beta globin at all is produced, it is called beta zero. When both beta genes gave mutations but still produce a significant amount of beta globin, the outcome may be thalassemia intermedia.
At this age, liquid folic acid is appropriate.
Andy

All we are saying is give thals a chance.

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Offline surendra

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Re: hello everyone. I m little confused.
« Reply #6 on: January 24, 2011, 03:37:05 AM »
Thanks  Andy.

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Offline surendra

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Re: hello everyone. I m little confused.
« Reply #7 on: January 24, 2011, 03:39:56 AM »
when should I check her ferritin level? She is taking transfusion from last 5 months. Any other tests U would recommend her.

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Offline Andy Battaglia

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Re: hello everyone. I m little confused.
« Reply #8 on: January 24, 2011, 03:44:53 AM »
Have the ferritin checked after 10 transfusions. Also, tea with meals helps prevent iron from being absorbed from food, so drinking tea should be encouraged once she is old enough.
Andy

All we are saying is give thals a chance.

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Offline surendra

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Re: hello everyone. I m little confused.
« Reply #9 on: January 25, 2011, 03:40:05 AM »
hello Andy.
               As u now my baby is beta zero major. during my pregnancy I was anemic. suffered from jaundice in 7-8 months in pregnancy. Hb level goes down 6.6 . Then my doctor gave me iron suppliments  in form of injections. would it effect on my body.
                    We(me and my husband) have done our Hb electrophoresis. But reports are still to come.







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Offline Andy Battaglia

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Re: hello everyone. I m little confused.
« Reply #10 on: January 25, 2011, 04:10:18 PM »
It's common for women to become iron deficient during pregnancy because of the added blood demand, so no worries about being given iron when you were pregnant.
Andy

All we are saying is give thals a chance.

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Offline surendra

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Re: hello everyone. I m little confused.
« Reply #11 on: January 25, 2011, 05:33:10 PM »
In the report I have been Thal trait.
Hb A2 estimation 6.7% of mine and 6.5% of my husband.
Hb on HPLC A+A

 

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