0
A 36-year-old African American male presents for further evaluation of mild anem ia. Patien t reports feeling well and is active in several types of sports with no limitation . There is no h istory of bleeding or episodic bone pai n. Physical examination reveals no hepatosplenomegaly or lymphadenopathy. Laboratory evaluation reveals hemoglobin level of 1 2 .1 g/dl, mean corpuscular volume (MCV) of 62 fl, red blood cel l count of 6, 1 00,000/pl, and platelet count of 25LJ,OOO/pl. Hemoglobin electrophoresis was performed and revealed a normal pattern . Peripheral smear is shown below.
What is the most likely diagnosis?
- Alpha thalassemia silent carrier
- Beta thalassemia trait
- Alpha thalassemia trait
- Beta thalassemia intermedia
- Iron-deficiency anemia
Medicine
C. Alpha thalassemia trait results from a deletion of 2 alpha globin genes. The clinical phe-notype is that of mild hypochromic microcytic anemia in an asymptomatic or minimally symptomatic individual. Hemoglobin electrophoresis is typically normal in contrast to increased HbA2 fraction seen in cases of beta thalassemia. Mild elevation in HbF can be seen. Microcytic polycythemia is a distinguishing feature that differentiates thalassemic disorders from iron deficiency, and thus the ele-vated RBC count in this case is more consistent with thalassemic disorder than iron deficiency.
need an explanation for this answer? contact us directly to get an explanation for this answer