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4 Years Old Having Low Haemoglobin. Is There Any Complication?

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Posted on Mon, 29 Oct 2012
Question: Good morning Doctor my son is know 4Yrs old every time hb level is low 8.5 gm/dl to maximun 11.8 gm/dl normocytic&mild hypochromic ,mild anisocytosis microcytes,occasional reactive lymphocytes

RBC 5.6 MILL/CUMM,4.9MILL/CUMM MONOCYTES SOMETIME ITS 8 TO 14 I JUST WANT CLEAR ANSWER FROM U DOCTOR I M VERY MUCH WORRIED ABT MY CHILD PLS REPLY MY QUESTION AS SOON AS POSIBBLE Thanking you
doctor
Answered by Dr. Rajiv K Khandelwal (7 hours later)
Hi,

Thank you for your query.

I can understand your concern of low haemoglobin. I would have appreciated if you had mentioned about the medications given and what the doctors are suspecting. From the reports it appears that he needs further investigations to come to a definite diagnosis. I can suggest the following investigations:
1. Haemoglobin electrophoresis
2. Total serum iron
3. Iron binding capacity
4. Stool for occult blood
The above investigations are to rule out any haemoglobinopathy, to know the iron status and to rule out any loss of blood through the stools.

Apart from the investigations, it shall be better to know the family history of any blood related disorder.

I hope I have responded to your query to your satisfaction. Please feel free to revert back with any clarifications and to share any other details which may assist us to guide you.

Wishing your son all the best...

Regards,

RKK

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rajiv K Khandelwal (1 hour later)
Good Morning

Dr XXXXXXX Thanks for reply medication is continue for short time orafer and its stop because of hard motion constipation sometime low Bp the investigation which u ve said i will complete and revert u bck

thanking you
XXXXXXX
doctor
Answered by Dr. Rajiv K Khandelwal (10 minutes later)
Hi XXXXXXX,

Thank you for the update.

If the Hb goes up to 11.8 g% from 8.5 g% after giving Orafer then most probably your son has iron deficiency anaemia. In iron deficiency anaemia, the medicine has to be given for 2-3 months after the Hb comes to normal so that the body stores of iron are replenished.

Yes, iron preparations do cause constipation in some. In this situation it is better to increase roughage in the diet and reduce the dose of medicine instead of stopping it. Increasing XXXXXXX leafy vegetables is going to serve dual purpose - increase roughage thereby reducing constipation and also provide natural forms of iron.

Please do revert back with the investigations, so that I can rule out other causes.

I hope I have provided updated information to your satisfaction.

Wishing your son all the best...

Regards,

RKK

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rajiv K Khandelwal (1 hour later)
Thanks Dr i will revert u in a week
doctor
Answered by Dr. Rajiv K Khandelwal (35 minutes later)
Hi XXXXXXX,

Thanks for the information and I shall wait for them. I hope my earlier response were to your expectations. You may close our discussion for now and rate my answer.

Regards,

RKK
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Rajiv K Khandelwal

Pediatrician

Practicing since :1976

Answered : 1872 Questions

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4 Years Old Having Low Haemoglobin. Is There Any Complication?

Hi,

Thank you for your query.

I can understand your concern of low haemoglobin. I would have appreciated if you had mentioned about the medications given and what the doctors are suspecting. From the reports it appears that he needs further investigations to come to a definite diagnosis. I can suggest the following investigations:
1. Haemoglobin electrophoresis
2. Total serum iron
3. Iron binding capacity
4. Stool for occult blood
The above investigations are to rule out any haemoglobinopathy, to know the iron status and to rule out any loss of blood through the stools.

Apart from the investigations, it shall be better to know the family history of any blood related disorder.

I hope I have responded to your query to your satisfaction. Please feel free to revert back with any clarifications and to share any other details which may assist us to guide you.

Wishing your son all the best...

Regards,

RKK