Anemia types and test

21 yrs/M Engineering Student came with c/o Loss of appetite. general weakness weight losss no c/o pruritis, breathlessness.bipedal edema.cough. no c/o Pr bleed,Hematemesis. deny any addiction Past h/o Blood transfusion 2years back for low Hb,no details available right now,advised to bring all old papers. O/E Yellow discoloration of Skin,upper bulbar conjunctiva present. Pr 78bpm. bp120/50mmhg wide pulse pressure RS clear Spo2 99at RA PA Soft NT No Hepato,splenomegaly. urgent cbc lft done. cbc s/o Hb 4.0gm%,WBC 3500,Plt 413000. LFT= S/O raised conjugated bilirubin 1.64,Unconjugated 0.87mg/dl TB 2.51mg/dl Sgot/Pt 83.4/77.4 Alp 281. ?Hepatocellular Jaundice. plan for Supportive rx fr hepatitis,BGCM,Bld transfusion,Urine R &M,Usg Abdo,Viral markers hepatitis,RFT,SE,Complete LFT,Bt,Ct,PT/INR. please comment on Diagnosis further line of investigations and management.




21 years old male with no blood loss from any sources with HB.- 4 gms and past history of blood transfusion needs thorough evaluation as to cause of anaemia .LFT derangement is secondary to anaemia . Get a Hb electrophoresis done to rule out thalassemia, osmotic fragility to rule out hereditary spherocytosis, sickling test to rule sickle cell anaemia . Loss of weight and appetite gives a hint to rule out malignancy like lymphoma , leukaemia and an Ultrasound scan of abdomen will help further evaluation . A bone marrow examination may be required if all other tests are inconclusive

Thank you doctor

Evaluate for megaloblastic Anemia & Thalassemia or a viral hepatitis, USG W/A

Evaluate for megaloblastic anemia Or viral hepatitis. Go for same investigations u are planning.

Thank you doctor

Combination of recurrent anemia, anorexia, hyperbilirubinemia, Leukopenia, point out to 1) Megaloblastic ANEMIA 2) Hemolytic ANEMIA CBC showing RBCs larger than 100, increase in RETI count, increased LDH , bone marrow evidence for megaloblasts will confirm megaloblastic anemia. Typical PS picture, low haptoglobin level and positive fragility test, hemoglobin electrophoresis will suggest hemolytic anemia .

Rule out hemolytic anemia ..Advise for sickling test and Hb electrophoresis..Adv..usg abd and pelvis to rule out gallstones..

Thank you doctor

Advise for investigation of thalassemia,hb typing , hepatitis,sonography of the abdomen

R/o hemolytic jaundice P/h of low hb and had BT Present hb is 4gm needs BT

Thanx dr Dinesh Gupta


Severe Anemia Urgent need 4 unit PRBC BLOOD TRANSFUSION CHECK IRON PROFILE, b12 folate in blood

Agree with Dr Parveen Sir

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