What is the outlook for a child with abnormal hemoglobin?

Hi,

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Based on your query and attached report (attachment removed to protect patient identity), my opinion is as follows:

1. Looking at the report of HbD trait (hemoglobin D), the prognosis is excellent.
2. The child will be very rarely transfusion dependent and mostly asymptomatic.
3. However, in future, counseling will be necessary as this heterozygous variety could turn into homozygous variety with other hemoglobinopathies such as sickle cell disease, thalassemia, etc., and affect the future generation.
4. The child will have mild splenomegaly and rarely hemolysis, otherwise will lead a normal life.
5. Risk of malarial infection will be very low due to this particular hemoglobin variety.
6. Maintaining good nutrition should be adequate and no other management will be essential.

Hi,

Welcome back to icliniq.com.

1. No, beta thalassemia minor or trait cannot be ruled out. DNA analysis could be helpful.
2. As the levels of HbA2 (hemoglobin alpha 2) are very high, the HbD trait is strongly suspected. As the hemoglobin is near normal, possible mild disease with rare symptoms can only be thought of.
3. HbA1 will be absent or very mild in thalassemia major or intermedia. However, beta thalassemia minor cannot be ruled out based on electrophoresis.
4. In the future generation, when the girl here is planning for a family, at that point, genetic or electrophoresis test of the boy will be compulsory to rule out any hemoglobinopathies. If both have some hemoglobin disorder, then it can get compounded and the risk for the newborn is high.
5. For the girl, the prognosis is excellent, as she could survive with mild disease and will be rarely symptomatic.