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Thursday, October 23, 2014
Bleeding and Clotting Disorders
Anemia without iron deficiency
My 16yr. old daughter has had recurrent anemia over the past 2 years. She is a competitive cross country runner. Six months ago she was prescribed repliva. When her hemoglobin failed to recover we added 65mg of ferrous sulfate to the repliva regimen for a total of 215mg daily (repliva and otc supplement). Over the past 4 months she has had 3 cbc and serrum ferritin blood tests. The first test on 8/5 her hemoglobin was 11.7 g/dl with abmormal values of rbc count = 3.76, rdw = 15.7. Her serrum ferritin at this time was 44. The second test a month later on 9/4 her hemoglobin was 11.8 g/dl with abnormal values of rbc count = 3.76, rdw = 15.1. Her serrum ferritin at this time was 59. The third and last test on 11/10 her hemoglobin was 11.6 g/dl with abnormal values of rbc count 3.76. rdw was normal on this test at 13.4. Her serrum ferritn at this time was 67. Her iron storage is increasing (44 to 67)but her hemoglobin is not recovering (ll.7 to 11.6). Any advice would be appreciated.
It is not possible to make any specific recommendations in this forum with only limited information, but on the surface, it does not appear that iron deficiency is the problem with your daughter.
I would encourage you to speak to your daughter's physician about other things that may be causing the anemia, and also consider a referral to a pediatric hematologist in your area who might be able to provide more information.
Spero R Cataland, MD
Associate Professor of Clinical Internal Medicine
College of Medicine
The Ohio State University