thalassaemia

My daughter is 11 months old. She is very weak and also underdeveloped for her age. A blood test has shown that she has low haemoglobin count (5g per 100ml) and nucleated red blood corpuscles in peripheral (circulating) blood. What could be reasons behind this? Is there a remedy?

Your daughter is probably suffering from inherited haemolytic anaemia, which is a common cause of thalassaemia. If both the parents are thalassaemia carriers, then the child born to them may suffer from thalassaemia (major). You should take you child for certain investigations like haemoglobin electrophoresis, high-performance liquid chromatography (HPLC), etc for confirmation. The only treatment is blood transfusion every month and medication for iron chelation (removal of extra iron from blood). You should consult a haematologist for proper diagnosis and treatment.

prenatal test

I am a 28-year-old woman and got married three months ago. I am a thalassaemia carrier and so is my husband. What should we do now? How can we avoid the birth of a thalassaemic child?

Ideally, two thalassaemia carriers should not marry. In case they do marry, prenatal diagnosis for thalassaemia is necessary to avoid the birth of a thalasaemic child. When the foetus is 10 weeks old, you should go for chorionic villous sampling (CVS) which involves taking out foetal cells for prenatal diagnosis of thalassaemia. If the test is positive, then medical termination of pregnancy is advised. Moreover, couples expecting a child should go for a blood test to know their carrier status.

blood cancer

My husband (34) has been suffering from an unexplained fever for the past one month. He has become very weak and pale. Medicines prescribed by doctors have failed to cure him. According to a complete blood count (CBC) report, his haemoglobin is 8.2g per 100ml, total count is 74,000 and platelet count is 41,000. Differential blood count shows 40 per cent blast cells (imperfectly developed cells) in peripheral blood. Doctors suspect he has leukaemia. What should I do now?

First, your husband has to undergo special tests, including those of the bone marrow, to confirm the cause. If the case is found to be acute leukaemia, immediate hospitalisation is advised. He should be treated with intensive induction therapy for leukaemia. Acute leukaemia can be of two types. The first type, myeloid leukaemia, can be treated by four or five courses of intensive chemotherapy followed by bone marrow transplantation in young patients. Treatment for acute lymphatic leukaemia continues for two to three years. Consult a haematologist for proper treatment.

Pregnancy anaemia

I am 16 weeks pregnant. I am suffering from lots of vomiting and am unable to eat normally. These days, I am becoming progressively weak and pale. I am a vegetarian. What is the remedy?

You are probably suffering from nutritional anaemia due to pregnancy. You have to go for complete blood count test. If the CBC report shows a low haemoglobin count, low total and platelet counts and if estimation of iron, vitamin B12 and folate (folic acid) levels in the blood are low, then it is the case of nutritional anaemia. You should take adequate amounts of Vitamin B12, folic acid and iron.

Anaemic child

My sister’s blood group is B negative. Her new-born son is suffering from jaundice and anaemia. He is pale and his bilirubin count is 25mg and haemoglobin count is 6g per 100ml. Please advise.

The child is perhaps suffering from haemolytic disease found in new-borns due to Rh incompatibility. First, the blood group of both mother and child need to be identified. Then a Coombsx test is necessary to detect Rh incompatibility (mother is Rh negative and baby is Rh positive). In case the report shows Rh incompatibility, then exchange transfusion of blood is needed routinely to prevent brain damage of the child due to high bilirubin level.