Can somebody give the clarifications regarding the test results?

I am a new member here. I do not know whether I am in right place to write this or not.

But please help me. I need guidance.

My four and eight months son was ordered hemogram, TIBC and Hb electrophoresis. He had a mild anemia and was on iron supplement earlier. His Hb was in the range of 10-12 always though!! Sometimes when he was ill, we did hemogram and found that he had microcytic hypochromic RBC's, though not always. But his Hb was nearly normal and not significantly low.

So we got it done and below are the reports of the recent investigations. We gave the sample and all the tests were done on the same sample. he was not on the iron supplements recently.

Hemogram:

Hb 11.9 (Range: 11.5-13)
RBC 4.54 (Range 4.5 to 5)
WBC 8400 (Range: 4000-10000)

Differential Count:
Neutorphils 43% (Range: 40-70)
Lymhocytes 50% (Range: 20-45) (He is recently recovered from amebiasis)
Eosinophils 6% (Range: 0-6)
Monocytes 1% (Range: 1-8)
Basophils 0% (Range: 0-1)

RBC Indices
HCT 35.6% (Range: 40-54)
MCV 78.4 (Range: 76-96)
MCH 26.2 (Range: 27-32)
MCHC 33.4 (Range: 32-36)
RDW-CV 13.2 (Range: 11.5-14.5)
Platelet Count 384000 (Range: 150000-450000)

Platelet Indices
MPV 7.8 (Range: 7.4-10.4)
PDW 8.8 (Range: 15.0-17.0)

Peripheral Smear Report
Platelet: Adequate
Parasites: Negative
WBC Morphology: Within normal limits
RBC Morphology: Normocytic Normochromic
Comment: Within normal limits

TIBC Report:
Iron 78 (Range: 35-150)
Total Iron Binding Capacity 325 (Range: 250-450)
% Saturation 24 (Range: 13-45)

Hemoglobin Electrophoresis Report:

HbA1 93.6% (Range: 94.3-98.5) (This is on a lower side)
HbA2 2.5% (Range: 1.5-3.7)
HbC 0.0% (Range: 0.0-0.0)
HbD 0.0% (Range: 0.0-0.0)
HbF 2.3% (Range: 0.0-2.0)
HbS 0.0% (Range: 0.0-0.0)
Unknown Unidentified Peak 1.7 (Range: 0.0-2.0)
Hemoglobin Variant Analysis: Mildly elevated HbF for the age of the patient. Significance?
Advice: Parental hemoglobin variant analysis, if clinically indicated.
Test Method(s): Hemoglobin variant analysis, Blood Hb Variant (HPLC)


I read a lot on the internet regarding Thalassemia and its different types. But,as I am not a doctor and do not correlate anything of the above clinically, I do not know what these reports mean?

Do you find anything significant with respect to the above tests and Hb electrophoresis?

Please help me. I am anxious.

Thank you very much for your valuable time reading this.

I posted earlier and got no replies. Please let me know regarding the results.

Aniket

Hi Aniket,

I was traveling and was not able to reply earlier. The RBC indices suggest nothing as they are all normal, yet the electrophoresis suggests possible thal minor, but it is not conclusive. Electrophoresis of the parents may shed some light on this. Since iron deficiency can also cause small red blood cells, this may be the cause if his iron numbers have changed since he was on iron. His current iron numbers look good. If it is thal minor, it's not reason for much concern, as this is not a serious condition. It is possible that another hemoglobin variant is present, according to these results, so electrophoresis tests for the parents may be able to determine if there is another variant present.

Thank you very much Andy !!

Yes, as you say it may be thal trait.

Both of the parents are very normal though no hb electrophoretic investigations are carried out.

The hb variant in the sample which is mentioned as unidentified peak is also within the normal limits.

The child otherwise is healthy, active and growing well. No problems with it at all.

I would like to know whether we should be concerned about it??

I am sorry to bother you. I understand that you are busy, but I hope you can apologize me.

Best wishes
Aniket

Hi Aniket,

It may not even be thal trait, but if it is it is certainly nothing to be concerned about. His Hb is normal as is his growth and activity level. Most thal minors don't even know they are carriers because symptoms are mild if any are present. If he is a minor he most likely fits in this category. Eventually it would be good to learn if it is thal trait, as a partner should be tested before having children if one is known to carry thal trait.

Thanks a ton Andy!!

It is nice to see that there are helping angels like you around to help clarify some of the doubts.

Thanks and God Bless you

Aniket

Both of the parents are very normal though no hb electrophoretic investigations are carried out.

Thal Minor's do not know about their status until they get tested as they are healthy. I think the Electrophoresis test should be done to get to a conclusion