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What Do These Blood Reports In A Beta-thalassaemia Carrier Indicate?

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Posted on Mon, 21 Sep 2015
Question: Have done blood test of my spouse( Age 39 yrs ) and detected "Consistent with Beta-thalassaemia carrier state". Hb 8.8 , RBC 4.64 m/cu.mm , MCV 67.5 fl, MCH 19.0 pg RDW : 18.1 %

HPLC of Hb

HbF : 0.5 % , HbA2 : 5.2 % , Abnormal Hb : None.

F Concentration = 0.5 %
A2 Concentration = 5.2 %

Reticulocytes interpretation

Increased in : Hemolytic anemia, blood loss ( before development of iron deficiency) recovery from Iron, B12 or folate deficiency or from drug induced anemia.

Decreased in : Iron defeciency anemia , aplastic anemia, anemoa of chronic disease , megaloblastic anemia, sideroblastic anemia , pure red cell aplasia , renal disease , bone marrow suppression or infiltration , myelodysplastic syndrome.

Report states
Hb 8.8
Erythrocyte Count 4.6 m/cmm
Total leucocyte count 8160/cmm
Neutrophils 59%
Lymphocytes 34%
Monocytes 5%
Eosinophils 2%

RBC : Predominantly hypochromic mycrocytic. Anisocytosis , a few elliptocytes, leptocytes & occasional tear drop cells seen

Platelets : Adequate


How severe is this ? And as per above mentioned report what should the course of treatment
doctor
Answered by Dr. Anil Parth Desai (1 hour later)
Brief Answer:
There is no need to worry ,however I would recommend the following steps-

Detailed Answer:
Hello sir,
I did review your concern and the reports in detail too. There are 2 aspects to my answer and i will discuss each in detail as following-
1) Your wife has hemoglobin of 9 and is having beta thalassemia trait. This is generally not a very serious condition and is commonly seen in XXXXXXX subcontinent. Infact it gives protection against severe malaria infection. However, it does cause mild anemia in the range of 9-11g/dl. Since your wife has hemoglobin in lower range of this I would recommend additional biochemical study in form of Iron studies to rule out a concomittant iron deficiency anemia. Reticulocyte count is increased but if corrected for anemia it falls in normal range.
Rest platelets and WBCs are normal and microcytic hypochromic rbcs are seen in both iron deficiency anemia and thalassemia and in women they can occur together due to improper diet or increased loss through menstruation bleeding so it is necessary to separately diagnose both condition and treat. Beta thalassemia carrier or trait has no specific treatment needed or even available.
2) However, it is an important diagnosis for your family perspective. If you have children or are planning for any future children I would recommend your and your children's hemoglobin HPLC study to see for a possibility of thallassemia major disease occurrence in future children or thalassemia trait in any of your present children for their future families.
So all in all, my recommendations are-
1) iron studies for your wife- serum iron, serum ferritin, TIBC.
2) family study for hemoglobin status.
I hope this helps sir.
Let me know if you have any more questions or concerns.
Wish you all the best.
Sincerely,
Dr Parth Desai.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Anil Parth Desai (37 minutes later)
What type of foods are recommended in this situation to improve Hb level. Due to this is there any possibility other health problem.

I am married for almost 19 years and have a son of 17 years. I will get all the test done but how far there is a possibility of this problem to be found in him. Just to mention I have almost normal Hb level as per last report.
Is there any need of BMT , and for that which is the best hospital in XXXXXXX and approximate cost for that.
doctor
Answered by Dr. Anil Parth Desai (10 minutes later)
Brief Answer:
Hi there is no need for BMT.

Detailed Answer:
Hello sir,
1) the foods that can improve hemoglobin levels, by supplementing with iron and magnesium and zinc are generally green leafy vegetables like spinach, sunflower seeds, tofu, iron fortified wheat flour if available in XXXXXXX
this can be safely consumed and does maintain nice iron supplementation.
2) Since your son is 17 years old and doing fine, I am pretty sure he does not have risk of beta thalassemia major disease as it starts manifesting badly from 6 months to 1 year of life needing multiple blood transfusion. However, it is better to get his blood tested so that we identify if he is a carrier (there is 1 in 4 chance or 25% chance by mendelian laws of genetics). In that case he needs no treatment but when he gets married these things come in picture for his future offsprings if his future wife also turns out to be beta thallassemia trait.
3) There is no need for BMT required in this case sir as thallassemia carriers are as good as normal people with slightly less hemoglobin but no major problem. just have a healthy diet and lifestyle and there is no concern.

I hope this helps
Let me know if you have any more questions or concerns sir.
Wish you all the best.
Sincerely
Dr Parth Desai.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Anil Parth Desai (7 hours later)
Hi Dr Parth Desai

Yesterday I was bit tensed and got relieved with your answers. Thanks a lot doctor.

Since she feels week and wants to improve health we started protein powder , multivitamin and multi mineral fortified health supplement & Tri Iron folic acid( containing Energy , Protein , Fat , carbohydrate , vit c , folic acid , spinach dehydrate etc ) of Amway company of our own.
Can she continue these currently ?

Where are you stationed and may I have your contact number, to enable us for future physical visit to your clinic.


Best Regards

XXXXX
doctor
Answered by Dr. Anil Parth Desai (1 hour later)
Brief Answer:
I am currently working in united states so will be unavailable for clinics.

Detailed Answer:
Dear Mr XXXXX,
I am actually currently working in united states hence will not be able to directly address the patient. however, I am always available regarding any query through healthcaremagic support with which I am strongly affiliated and you can ask me any concern or question anytime.
The food supplement you mentioned above is good for her health and you can continue with that along with a healthy and nutritious diet.

I hope this helps
Wish you all the best.
Sincerely,
Dr Parth Desai.
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Anil Parth Desai

Pathologist and Microbiologist

Practicing since :2009

Answered : 593 Questions

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What Do These Blood Reports In A Beta-thalassaemia Carrier Indicate?

Brief Answer: There is no need to worry ,however I would recommend the following steps- Detailed Answer: Hello sir, I did review your concern and the reports in detail too. There are 2 aspects to my answer and i will discuss each in detail as following- 1) Your wife has hemoglobin of 9 and is having beta thalassemia trait. This is generally not a very serious condition and is commonly seen in XXXXXXX subcontinent. Infact it gives protection against severe malaria infection. However, it does cause mild anemia in the range of 9-11g/dl. Since your wife has hemoglobin in lower range of this I would recommend additional biochemical study in form of Iron studies to rule out a concomittant iron deficiency anemia. Reticulocyte count is increased but if corrected for anemia it falls in normal range. Rest platelets and WBCs are normal and microcytic hypochromic rbcs are seen in both iron deficiency anemia and thalassemia and in women they can occur together due to improper diet or increased loss through menstruation bleeding so it is necessary to separately diagnose both condition and treat. Beta thalassemia carrier or trait has no specific treatment needed or even available. 2) However, it is an important diagnosis for your family perspective. If you have children or are planning for any future children I would recommend your and your children's hemoglobin HPLC study to see for a possibility of thallassemia major disease occurrence in future children or thalassemia trait in any of your present children for their future families. So all in all, my recommendations are- 1) iron studies for your wife- serum iron, serum ferritin, TIBC. 2) family study for hemoglobin status. I hope this helps sir. Let me know if you have any more questions or concerns. Wish you all the best. Sincerely, Dr Parth Desai.