Greetings All,
To make things short, my son is now about 2 years old. Since birth he was breast fed until he was 12 months. After that he was on cow’s milk, no powder milk or cereal was giving to him and his diet was depending on the milk mainly with little hard food. We discovered he has Low HGB through normal CBC test when he was 9 months old. He did take iron supplement but not for long. His HGB went up a little and then we stopped giving him the Iron Supplement regularly due to some problems the supplement caused. Until he turned 20 months old we did another test and found out his HGB is still low 10.7. From Jan 5th, 2013 until yesterday he is taking iron supplement regularly. Between these two month we decided to do an Iron Study test and Peripheral Smear tests , results were as follows.
CBC Test: March 10th, 2013 (age 23 months)
June 2012 FEB 12 March 10th, 2013
WBC 12.9 10.3 10.6
RBC 4.61 5.73 * H 5.32
HGB 10.9 10.5 * L 10.5
HCT 29.3 35.8* L 31
MCV 63.5 62.5* L 58.3
MCH 23.6 18.2 *L 19.7
MCHC 37.2 29.1 *L 33.9
RDW 17.6 16.4 *H 22.7
Platelet 404 421*H 301
Differential WBC
Netrophis 17*L
Lymphocytes 71*H
Moncytes 05*H
Eosinphils 06H
basophils 01*H
Peripheral Smear TestRed Blood Cells exhibit anisopolklicoysis with mild hypochormia
- Microcytes polychromatophils and occasional target cells are present.
-lymphocytosis is evident, few activated lyphocytes are seen.
thormbotosis is evident, platelet morphology is normal
- no abnormal celss or haemoparsits seen.
advised
Iron Study
Ferritin
Haemoglobin Electrophoresis
IRON STUDY TESTIRON 20 *L Ug/dl
TIBC 423
% Saturation 5 %.
Hemoglobin electrophersis test results
Haemoglobin A 97.70 %
Haemoglobin A2 2.3 %
I got two opinions from two doctors , the first doctor who did the electrophoresis test concluded my son has Iron Deficiency Anemia and I should watch his diet and give him more iron rich food.
The other doctor which is more older Hence more experienced who did his normal CBC test yesterday and found that even with iron supplement for 2 months did not increase his HGB. suggested he could be carrying thalassemia gene.?!!! I showed him the Electrophoresis test and how it shows everything is normal. He mentioned that electrophoresis test is not usually sufficient to detect Thal Minor. he said, he reads out the CBC test and can tell from the MCV and RDW etc that he might be Thal minor. Even after that he still prescribed him Iron supplement for another 30 days
!!!
Now here are my questions, and kindly answer them because i am confused :
1- what more test I could do to make sure he is not Thal minor? i did CBC , iron study, HGB electrophoresis
2- Looking on his CBC , can you tell if he is Thal Minor
3. Looking on his mother different CBC, could be she has Thal minor. ( knowing that she is pregnant now and has low iron)
Pregnant Not Pregnant (breast feeding)
WBC 11.8 11.1
RBC 4.96 5.00
HGB 10.8 11.7
HCT 36.2 36.4
MCV 73 72.8
MCH 21.7 23.5
MCHC 29.8 32.2
RDW 14.3 18.1
Platelet 290 307
4. how long for iron deficiency to be corrected after taking iron supplement.
5. is two month enough to correct the iron ferritin and HGB reading. Or should be on supplement more than 2 months.
6. is it normal that his electrophoresis test does not show HBG F reading.
7. can a person inherit Thal Minor from his grand parents.
Hope I explained well my child’s case.
Regards,