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Sickle Cell Anemia

Thalassemia Trait vs IDA

01/15/2010

Question:

Had abortion,D&C in 2007 & 2008. My hemoglobin was 8+ post D&C. I was given iron IVs then tabs. After my last abortion, used to have 2 menses in a month. My gyne gave me contraceptives to correct my menses as this was due to hormonal disturbance caused by abortion,she said. I stopped taking contraceptives after 8 months then my problem about my menses returned. Went to see a gyne again,had CBC ( Dec. 10,2009) : Hemoglobin = 76gm/ml Hematocrit 0.23 Leukocyte count 7.1 (normal value 5.0- 10.0) Neutrophils 0.70 Segmenters 0.70 Lymphocytes 0.28 Monocytes 0.02 Bleeding time 2min 04sec Coagulation time 4min 20sec

Peripheral Bloob Smear Report:(Dec. 12, 2009) Red Blood Cell Morphology: normochromic, microcytic RBCs w/mild poikilocytoses (ovalocytes +) White Blood Cell: adequate Differentials: Segmenters 68 (no toxic granules/vacuoles) Lymphocytes 32 Platelet adequate; occuring singly;no large/abnormal forms no immature cells IMPRESSION: normochromic microcytic red cells COMMENT: Thalassemia Trait vs IDA

I was given iron tabs(Trihemic)2tabs a day. After a week (Dec. 17,2009) my Hemoglobin was 107g/L Hematocrit 0.32

My gyne told me to continue my iron tabs BID and to consult a Hematologist(I didn`t went to see one yet).

From my reading i learned that iron tabs is contraindicated in some forms of thalassemia I want to know if it applies to my case.

I want to know more about my case.

I want to know if my anemia is somehow related to my menses problem. Since taking iron tabs recently, my period came after 30 days from my LMP.

Anticipating so much for reply. Wishing you more power.

Answer:

It is relatively easy to distinguish iron deficiency from thalassemia by doing serum ferritin and iron and tibc. The most likely diagnosis in this case is iron deficiency but lab evaluation will complete this.

For more information:

Go to the Sickle Cell Anemia health topic, where you can:

Response by:

Eric H Kraut, MD Eric H Kraut, MD
Professor of Hematology
College of Medicine
The Ohio State University