Need advice

Hi All,

I need your opinion about my wife. The latest Blood test report shows:

RBC Count - 5.24
HB - 9.5
Hematocrit - 31.5
MCV - 60.1
MCH - 18.2
RDW - 21.5
Hemoglobin A - 98.3
Hemoglobin F - <1
Hemoglobin A2(quant) - 1.7L

It was interpreted in the report that -Consistent with alpha thal trait & rule out iron deficiency.

In the previous report , the Ferritin was 3. So doctors recommended Iron suppliments daily.

Before she used to feel fatigue but now she feels normal.

My question is ,whether it is major/inter/minor thal.?
What should we do from here?
We are planning for pregnancy, is it ok?

Thanks in advance for your time & opinion.

Hello,

Welcome to thalpal.com. You have come to the right place to learn more about your wife's condition.

Looking at the reports, I cannot tell you for sure if she is Thal (Minor) or not but one thing is for sure - She is definately NOT a Thal (Major). Here is the reason why.
From : http://www.thalassemia.com/what_is_thal.html

Symptoms appear in the first two years of life and include paleness of the skin, poor appetite, irritability, and failure to grow.

Diagnosis of Alpha Thal Trait is very difficult with just a blood test. DNA analysis will give a complete picture of Alpha Trait.
View another link : http://www.thalassemia.com/gene_test.html

Individuals with alpha thalassemia trait usually have evidence of microcytosis and normal levels of hemoglobin A2 and F. Sometimes trait status cannot be determined by these screening tests alone. Results may be ambiguous for a variety of reasons. If iron deficiency is detected, an individual must be retested after completing iron supplement therapy. Occasionally, DNA testing that directly examines the alpha and/or beta globin genes is necessary. DNA testing is the only way to determine silent alpha thalassemia trait and the related hemoglobin trait called hemoglobin Constant Spring. DNA testing may also be necessary in order to allow for the option of prenatal testing.

It is important for individuals to be aware of their thalassemia trait status, particularly individuals of reproductive age. Depending on the hemoglobin type of a current or future partner, future children may be at risk for thalassemia disease or other related hemoglobin diseases. Prenatal and other testing options are available to couples found to be at risk for having a baby with disease.

Also, it would be best if you can get tested. If you are cleared of thalassemia trait - your child cannot be thalassemia (Major).

Thanks Narendra,

Some more information
My wife's height: 5 feet 5 inch
Weight: 135 pound

The report date in the prevoius post is 08/19/2011 & we had one more test before this one on 08/15/2011.
In 08/15 report, Ferritin was low - 3
so doctor recommended for Iron suppliment   & only after 4 days 08/19  we had another test.

                  08/15 report                                  08/19 report
RBC Count -  5.51                                             5.24
HB -             9.8                                               9.5
Hematocrit -  32.7                                             31.5
MCV -           59.4                                             60.1
MCH -           17.9                                             18.2
RDW -           21.9                                            21.5
Hemoglobin A -                                                 98.3
Hemoglobin F -                                                   <1
Hemoglobin A2(quant) -                                      1.7L


We haven't visited any Hematologist yet.

Thanks again,
Singh

 

Singh,

The MCV is so low that it seems iron deficiency must be part of the problem. Alpha is harder to detect, so I am assuming some HbH inclusion bodies were observed to give a diagnosis of alpha trait.

As Narendra mentioned, if you are clear of alpha trait yourself, there is no possibility of a child having HbH disease or worse. I would suggest a DNA analysis of your wife. If it proves she is an alpha trait carrier, you also need to be tested to rule out being a carrier yourself. Alpha is not easily detected, so a DNA analysis is the only sure method.

Thanks Andy for the valuable suggestions.

We will update here as we have any more information.

Thanks again.