MCV

Hi there,

I am a mother of two children, a girl now aged 5 and a boy aged 4 yrs old.  I am having difficulty in determining whether they have thal minor or not.  The doctors here simply check for major and disregard minor. 


RESULTS (boy):.
The MCV of my son at 3 months old was 72.  At three and a half years the MCV was 75, hb 12.4, red cell count 5.0, but his blood film showed a slight hypochromia and few microcytes and also HBF negative and the HBA2 is 3.4. (However on the same day the blood film was done in another lab and the result was normocytic and normochromic and the doctor had viewed only this result).  Blood test done recently shows that my son's hb is 13.0, MCV 71.6, MCH 23.9 and MCHC 33.4.
 
 
RESULTS (girl):
My daughter's MCV at 4 and a half years old was 79, hb 12.2, red cell count 4.7 , blood film is normocytic and normochromic, HBF negative and the HBA2  3.3. However one month earlier her MCV was 73.3, hb 11.9 and rbc 4.9.  BVlood test done recently shows that my daughter's hb is 12.8, MCV 74.7, MCH 25.0 and MCHC 33.5



I would really appreciate it if someone could help me interprete these results.
Thank you beforehand.
A confused mind,
Jade

Hello Jade,

These levels are slightly below the normal range and the level of HbA₂ above 2% means your kids are Thal. carriers.

But one thing is for certain that they are NOT Thal Major.

Just keep their Hb. and S.F in check when you feel that they are getting weak or pale.
Hopefully they will be fine and you don't have to worry too much.

Take care, Peace!

Hello

I guess that you shouldn't worry Jade as Sajid has told you.

and the level of HbA₂ above 2% means your kids are Thal. carriers.

I was told by my hema. that when HbA2 is above 3.4% this  indicates that you are a carrier or a minor. I guess this is a fixed number that doesn't change with differnt lab kits

Manal

RESULTS (boy):.
The MCV of my son at 3 months old was 72.  At three and a half years the MCV was 75, hb 12.4, red cell count 5.0, but his blood film showed a slight hypochromia and few microcytes and also HBF negative and the HBA2 is 3.4. (However on the same day the blood film was done in another lab and the result was normocytic and normochromic and the doctor had viewed only this result).  Blood test done recently shows that my son's hb is 13.0, MCV 71.6, MCH 23.9 and MCHC 33.4.
 
 
RESULTS (girl):
My daughter's MCV at 4 and a half years old was 79, hb 12.2, red cell count 4.7 , blood film is normocytic and normochromic, HBF negative and the HBA2  3.3. However one month earlier her MCV was 73.3, hb 11.9 and rbc 4.9.  BVlood test done recently shows that my daughter's hb is 12.8, MCV 74.7, MCH 25.0 and MCHC 33.5

Jade,

First of all, we should let you know. None of us are doctor's here. We just know a little bit, so you should seek professional consulting before reading too much into it. We might just say, it MIGHT be thal(minor) or MIGHT NOT be.

As far as I know, the MCV readings above show the red blood cells microcystic, but these results are muddy without the Ferritin levels. If the ferritin levels are NOT in normal range, the Hemoglobin electrophoresis are NOT accurate. Do you happen to know, the ferritin levels along with these readings?

The Hb levels of both children are both on the low end of normal, so if they do carry the thal trait, it doesn't seem to be causing any significant problem at present. What is important is to verify that they are carriers, so they know this for later in life when they choose to have children of their own. They need this information so that if they partner with another carrier, they know the risks of producing a thal major. Also, if you know they are carriers, it can help avoid unnecessary iron supplementation for anemia.

Hi Jade,

Although Electrophoresis can give a hint of what's going on, but know that it is just a HINT. You will also need the Serum Ferritin level checked. If it's too high then something might be wrong otherwise it might just be Iron deficient anemia.

However, if you really want to know the clear picture, then you can ask your doctor for the DNA test. Although at current levels of Hb, I don't think there is much to worry about. Just keep their blood counts in check and proceed further only if they are constantly dropping.

Take care, Peace!

hi

Thank you very much for your replies.  I'll keep checking their blood count.

Jade

Hi Jade, where are you geographically located, as blood parameters can slightly differ from ethnic origins as well as altitudes. The CBC reports are sligtly in favour of hyporomic as MCV and hemoglobin are low and MCH is bit low. However since A2 of the boy is in borderline its inconclusive to say whether he is normal for thalassemia minor, or he is iron deficient. I dont think your kids has serious form of hemoglobinopathy. As Andy said its always better to know for their future.

You should do ferritin tests along with the CBC's always because iron deficiency and thal minor look practically the same, plus you can't assess thal minor until the iron deficiency is corrected if present. Iron deficiency may also throw off electrophoresis tests. Whetever you do, don't supplement little kids with iron unless they are iron deficient.