2 months male child c/o yellow coloration of eyes, FTT, weight 3 kg B/H -FTND/ CIAB/ Birth weight 2.2kg/ First issue of Close consanguinity/ No NICU stay/ On top feeds with bottle O/E Icteric Pale Mild Hepatomegaly spleen Palpable , Gaseous abd distension, No H/O clay colored stools or staining of urine Rest NAD. Discuss

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U need to have nucleated RBCs, Polychromatophilic cells which shows the accelerated production from the marrow in responsive to the drop in Hb which s not given here. Without that usually we won't label as HEMOLYSIS. U check with pathologist one more. further u can do Other ancillary tests like LDH, HAPTOGLOBIN can be done for a much clearer picture. 1. One thing s clear whatever problem is there it's affecting only RBCs n that's not due to nutritional as evidenced by normal MCV,MCHC though mild increase in RDW. To think about thalassemia the kid s too young. Rather u have to think about some transient disturbance like drug intake n viral illness. 2. U have to approach like HEMOLYTIC DISEASE OF NEWBORN. both RH & ABO (ABO > RH) incompatibility can present up to 6 months. So check for this.
G6pd or thallasemia.do testing for parents for screening HB electrophoresis.then send for genetic analysis.start blood transfusion.give slowly.hydrate the child.rule out sepsis first.
Hemolytic anemia. .do g6pd levels. .hb electrophoresis may r may nt help as 2mnths old child..do LFT, TORCH screen thyroid profile. .sepsis screen
Hemolytic Anemia may be d/t G6PD, Abd USG fr hepatobiliary sys...
AIHA also possible as sequel of neonatal hepatitis.

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PS and LFT s/o hemolytic anemia either G6PD deficiency or thalassimia with early presentation. There is possibility of glucornidase deficiency ID hyperbilirubinimia if jaundice is present since 1wk of life. Need further evaluation
no H/O neonatal jaundice sir....thanks
कुमार कल्याण रस स्वर्ण युक्त 1 रत्ती सत गिलोय 4 रत्ती शहद मिलाकर सुबह-शाम सेवन कराएं, कुमार कल्याण रस स्वर्ण युक्त बच्चों की बिमारी के लिए अमोघ अस्त्र है पिछले 40 वर्ष से प्रयोग कर रहा हूं
R/o g6pd deficiency,AIHA,malaria there is definite sign hemolysis .rule out later 6 month of age any hemoglobinopathies further investigation of present issue.Transfused baby pack cell.
Dr. Rashid Vora sir please share your views
Haemolytic Anaemia.
Hemolytic Anemia

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