A 4-month-old infant of Asian heritage is seen for a well-baby check. Because of pallor, the physician suspects anemia and orders a CBC. The RBC count is 4.5 3 109/L, Hb concentration is 10 g/dL, and MCV is 77 fL, with microcytosis, hypochromia, poikilocytosis, and mild polychromasia noted on the peripheral blood film. These findings should lead the physician to suspect:

THALASSEMIA

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Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]

A	b-Thalassemia major
B	a-Thalassemia silent carrier state
C	Iron deficiency anemia
D	Homozygous a-thalassemia ( ____ / ____ )

Explanation:

Detailed explanation-1: -On the complete blood count (CBC), its measure is under 80 fL while normal MCV is between 80 to 100 fL. It is commonly seen in chronic iron-deficient anemia, anemia of chronic disease, sideroblastic anemia, and thalassemias but can also occur in other conditions.

Detailed explanation-2: -Low MCV and MCH indicate microcytic anemia, which can be caused by iron deficiency anemia, thalassemia or other hemoglobinopathies. It is necessary to determine the specific cause so that appropriate interventions can be taken.

Detailed explanation-3: -The most common causes of microcytic anemia in children are iron deficiency and thalassemia (algorithm 2) [1, 24]. The red cell distribution width (RDW) can be helpful in differentiating iron deficiency from thalassemia.

There is 1 question to complete.

MRCP UK EXAMINATIONS

ABDOMINAL

THALASSEMIA