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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What can be done for a mildly enlarged liver and mild anisopoikilocytosis with moderate hypochromia?

7 year old female child presents with weakness having a previous h/o blood transfusion at the age of 5 and 6 years of age.No such family h/o blood transfusion or thalassemia.Her blood reports reveal: hb-6gm%,WBC-8500/cc,N60L36M0E4B0,PBS-mild anisopoikilocytosis with moderate hypochromia.RDW-20.5%,Retic count-7.7%,PCV-22.6%,MCV-80.4,MCH-26.7,MCHC-33.2,CRP-0.34,Ur-43,Cr-0.5,LFT-WNL,Thyroid function test-NORMAL LIMITS,Urine RE ME CS-NIL,Stool RE ME OPC Occult blood-NIL,Serum Iron-122 (normal),ferritin-79.9 (n),TIBC-258 (N),G6PD-6.8 (N),LDH-687 (HIGH),HPLC Hb-HbA-96%,HbA2-2.6%,HbF-0.6%,Sputum AFB-nil,HRCT THORAX-normal,USG W/A-Liver mildly enlarged & others normal.
Tue, 12 Feb 2019
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  Anonymous's Response
's  Response
Hi,

In my opinion your doctor should go for Coombs testing to rule out hemolytic anemia. As your investigations are indicating towards hemolytic anemia, severe anemia, increased retic count, increase LDH and h/o blood transfusion.

Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Himani Saroha
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