Chronic anemia in pediatriconcall.com

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Question
A 18 year old boy a product of nonconsengeneous merrage,presented as chronic anemia under evaluatin since 2000. Pt was having c/o easy fatigability, palness of body,intermitant abdominal pain, swelling over body[diagnosed as iron deficiency anemia]. pt was positive for occult boold in stool repeatdly, investigated further with colonoscopy,USG And Rbc labelled GI bleed scan which were normal a urine routin ex normal Hb electrophorasis normal. A CT enteroclysis reveled jujunal wall thickning ?jujunal polyp. But there is no H/O frank blood in stool, no H/O recurrent enteritis. O/E marked pallor, mallor erythemaus rash over fase, mild hepato splenomegaly, no rash over body, no LNpathy,no arthritis. A younger sister of patient is also having anemia and abdominal pain intermittently but not investigated. So what is a final diagnosis.
Answer
What is the type of anemia? If it is normocytic normochromic rule out chronic renal failure, liver disease, HIV and other chronic diseases. If it is microcytic hypochromic anemia and stool for occult blood is positive, it may suggest iron deficiency anemia. Stool for occult blood may be positive if the child is on hematinics. If the stool examination was done when the child was not on hematinics, it suggests a bleed above the 3rd part of duodenum. In this case colonoscopy may not help and upper GI scopy may be required to rule out gastritis and H.pylori infection. If the stool for occut blood was positive while the child was on hematinics, then one may do serum iron studies and reticulocyte count, If retic count is low, bone marrow examination may be required. Back to All Questions

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