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Reason for CHRONIC MICROCYTIC HYPOCHROMIC ANEMIA despite treatment.

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Respected doctor
i am father of 10 years old boy , on chronic microcytic hypochromic anemia from the age 5 till now, enlarged kissing tonsillits, planned to remove tonsils ,on pre operative work up found prolonged prothrombime time (17 sec) and finally done complete coagulation factor diagonsed mild factor vii deficient , which corrected with normal plasma,
no history of bleeding or brisuing , mild hyperactive , normal in acadamics .,
he is on iron tablets of three different salts totally 150mg a day for past 5 days.,
morning - ferrous calcium citrate elemental iron50mg
noon------iron chelate complex elemental iron 30mg
night ----ferrous succinate elemental iron 70mg

his stools is green to black in colour, negative for occult blood test
i have attached his latest anemia profile blood investigation along with this query .,
i am totally confused that some doctors in our town hbg of 10.8 as normal and some of doctors replied as chronic anemia and some as to do full gastroscope , full colonoscope., and rbc labeled nuclear scan.,
this hbg was not corrected for the past 5 years inspite of iron and vitamin c supplements.,
deworming done for once in 3 months (400mg on 1st day and 400mg on 15th day)
so i need your opinion whether this is normal or not , and advice for further
please please advice further


Category: Hematologist

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Category: Hematologist
Dr. Prasad Eswaran is online now

Expert:  Dr. Prasad Eswaran replied 4 Days.

Thank you for your query at DoctorSpring.com.
Dear parent,
Hemoglobin of 10 g/dL and above is considerd normal for a 10 year old child. Mild hypochromic anaemia can be due to some intractable mucosal bleed which is insignificant. However, I would not suggest for colonoscopy or gastroscopy as his fecal occult blood test is negative.
Please continue on iron and vitamin supplements with a healthy balanced diet. He may be kept on 6 monthly or annual evaluation until his adulthood.
There will not be any major health concerns due to coagulation factor deficiency, but please remember to inform the medical practitioner about his condition during health visits. The child needs to be well educated on his condition and Badge or a card stating his health condition should be always be worn or kept with him. His teachers and his friends should be aware of his condition.
Please let me know in case you have any further queries.
Regards.


Patient replied :

Thanks for reply doctor I am mentioned using 3 different iron salts, ferrous succinate, ferrous calcium citrate and iron chelate complex,it's ok or any corrections needed and also its safe for elemental iron 150 mg a day as he is 10 years old
Please advise


Expert:  Dr. Prasad Eswaran replied 3 Days.

Thank you for writing to us again.
These medicines are ok as long as they are prescribed by a qualified medical practitioner. You may consult a haematologist in your city for a general physical examination so that a right prescription can be given.
Generally iron is an essential component of the diet needed for development. Different forms may be ok, but the ultimately absorbed part is elemental iron. So need to be concerned about different formulations.
Feel free to discuss further,
Kind regards,


Patient replied :

DEAR DOCTOR
I HAVE DONE SERUM HEPCIDIN LEVELS AND ALSO ATTACHED THE REPORTS ALSO
PLEASE ADVICE FOR FURTHER


Expert:  Dr. Prasad Eswaran replied 2 Days.

Hello.
Can you kindly upload the report again? It is not their in the dashboard. You could also email it to info@doctorspring.com.
Once you do, I will reply in this follow up.
Regards


Patient replied :

SIR
MAIL SENT TO INFO@DOCTORSPRING.COM
PLEASE ADVICE ANY OTHER INVESTIGATIONS


Expert:  Dr. Prasad Eswaran replied 1 Day.

Hello.
The values are in the normal range.
Hepcidin is a protein found in the body which prevents excessive absorption of iron.
A detailed review is available in www.intrinsiclifesciences.com/hepcidin-assay-info/
Please let me know your exact concern to guide you better.
Regards.


Dr. Prasad Eswaran
Category: Hematologist
Experience: 
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
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