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What should be done when hbg is 9.8 and mcv is 68?

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General Surgeon
Practicing since : 2002
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hello doctor as per your request my son is in elemental iron 100mg per day for another six months... still hbg is 9.8 and mcv is 68 and smear study microcytic hypochromic ... please advice for futher .. you told to do full renal evalution pls advice for the same
Posted Thu, 27 Feb 2014 in Child Health
 
 
Answered by Dr. Deepak Kishore Kaltari 14 hours later
Brief Answer: Further information required Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day I would kindly request you to get back to me with complete history and all the laboratory investigation done so far. I would like to have the following information 1. Duration of symptoms 2. Any associated fever or other complaints 3. Any family history of anemia 4. Any urinary complaints Will be glad to assist you further. Take care Best Regards Dr Deepak Kishore MBBS, MS, MCH Consultant Pediatric Surgeon
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Follow-up: What should be done when hbg is 9.8 and mcv is 68? 3 hours later
hello doctor 1.we notice anemia at age of three, till now the maximum hbg was 10.1 gm/dl lab investigation done in cmch vellore so far a. variant hb analysis normal pattern ,no beta thal b. negative for alpha thal.. c. negative for occult stool test d. prolonged pt ., complete coagulation factor suggest mild factor seven deficient 21% e. on elemental iron 100mg +celin 500mg for 18 months as advised by cmch f. no history of bleeding so far e. all other blood investigation like tyroid,iron studies ,eeg,electrolyte,calcium,vitd3 are normal 2. no fever for the past 2-3 years.,some flu like symptoms subside within 2 to 3 days his ht 132 wt 25.5kgs., enlarged tonsils advice for surgery in cmch finally dropped due to factor vii deficient., frequent ear infections controlled with augmentin 3. father hbg is 18 gm/dl and mother hbg is 11.4 gm/dl., younger sister hbg is 13.5 gm/d; 4. no urine complaints so far pls advice for further
 
 
Answered by Dr. Deepak Kishore Kaltari 1 hour later
Brief Answer: Bone marrow biopsy and urinary system evaluation Detailed Answer: Hi Greetings In the Presence of normal hematological parameters except low hemoglobin level, it's important to rule out selective rbc synthesis deficiency by doing Bone marrow aspiration/biopsy. Could you provide me the peripheral smear report including reticulocyte count. Also subclinical infection like Urinary tract infection (even in the absence of symptoms) Is to be ruled out as cause if chronic anemia. It would be very useful and beneficial if you could provide me the peripheral smear report. I will also discuss it with my Hematology colleagues and definitely will help you out in this matter . Take care Best Regards Dr Deepak Kishore Consultant Pediatric Surgeon
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Follow-up: What should be done when hbg is 9.8 and mcv is 68? 5 minutes later
doctor pheipheral smear study .as on dec 2013.... microcytic , hypochromia present , retics 0.60 thanks..
 
 
Answered by Dr. Deepak Kishore Kaltari 3 hours later
Brief Answer: Has bone marrow biopsy been done? Detailed Answer: Hi Greetings Has bone marrow biopsy been done? Further management and diagnosis can be arrived based on bone marrow biopsy. CMC Vellore has one of the finest hematological department. Take care Regards Dr Deepak
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