Background A 10-month-old Central American child was referred to the laboratory
ID: 145679 • Letter: B
Question
Background
A 10-month-old Central American child was referred to the laboratory for testing after being seen by a pediatrician. The phlebotomist noted that the child was very pale and listless. The following tests were ordered: CBC with platelet, reticulocyte count, total serum bilirubin, total serum iron, and total iron-binding capacity (TIBC), as well as a stool examination for occult blood, ova, and parasites. The results are listed below:
Parameter
Result
Reference Range
Hemoglobin
5.6 g/dL
10.5-13.5 g/dL
Hematocrit
24%
33-42%
RBC
3.5 x 1012/L
3.7-5.3 x 1012/L
WBC
10.5 x 109/L
6.0-18.0 x 109/L
Platelet
200 x 109/L
150-450 x 109/L
MCV
68.6 fL
74-91 fL
MCH
16 pg
23-31 pg
MCHC
23%
32-36%
Retic count
0.5%
0.5-2.0%
Total serum bilirubin
0.9 mg/dL
0.3-1.9 mg/dL
Serum iron
40 µg/dL
50-160 µg/dL
Serum ferritin
5 ng/mL
15-400 ng/mL
TIBC
465 µg/dL
250-400 µg/dL
% Saturation
8.6%
20-55%
The stool examination was negative for occult blood, ova, and parasites.
The child is suffering from anaemia.
The lab investigations characterises that he is suffering from iron deficiency anaemia as ferritin,hb, MCV,MCH are decreased and TIBC Is increased.
5. What is the appropriate treatment for this disorder?
Parameter
Result
Reference Range
Hemoglobin
5.6 g/dL
10.5-13.5 g/dL
Hematocrit
24%
33-42%
RBC
3.5 x 1012/L
3.7-5.3 x 1012/L
WBC
10.5 x 109/L
6.0-18.0 x 109/L
Platelet
200 x 109/L
150-450 x 109/L
MCV
68.6 fL
74-91 fL
MCH
16 pg
23-31 pg
MCHC
23%
32-36%
Retic count
0.5%
0.5-2.0%
Total serum bilirubin
0.9 mg/dL
0.3-1.9 mg/dL
Serum iron
40 µg/dL
50-160 µg/dL
Serum ferritin
5 ng/mL
15-400 ng/mL
TIBC
465 µg/dL
250-400 µg/dL
% Saturation
8.6%
20-55%
Explanation / Answer
This is the case of iron deficiency anemia, characterised by low hemoglobin, low mean corpuscular (MCV), mean corpuscular hemoglobin concentration (MCHC), low levels of iron and ferritin.
Treatment of the above disorder, depends mainly on the underlyning cause, whether it be blood loss, celiac disease, any parasitic disease. general treatment of this disorder includes administration of intravenous iron, consumption of iron-rich food items.
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