How to check and diagnose thalassemia

Speaking of anemia, I believe many friends know what it is and how to improve their anemia. But did you know that anemia is also divided into types, such as thalassemia. Although thalassemia is not common clinically, its harm is quite serious. Therefore, when you have symptoms of anemia, you must be diagnosed to see if it is thalassemia. You can read the analysis in this article for specific information on how to check and diagnose thalassemia.

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1. β-globin deficiency anemia (thalassemia)

(1) Severe peripheral blood shows microcytic hypochromic anemia, with red blood cells of varying sizes, enlarged central light-stained area, the appearance of atypical, target-shaped, fragmented red blood cells and nucleated red blood cells, stippled red blood cells, polychromatic red blood cells, Howe-Jones bodies, etc.; reticulocytes are normal or increased. The bone marrow showed significantly active proliferation of the erythroid system, with middle- and late-stage immature erythrocytes accounting for the majority, and the changes in mature erythrocytes were the same as those in peripheral blood. The osmotic fragility of red blood cells was significantly reduced. The HbF content is significantly increased, mostly >0.40, which is an important basis for diagnosing severe β-thalassemia. Skull X-rays show thinning of the inner and outer plates of the skull, widening of the lamellae, and the appearance of vertical short hair-like bone spurs between the bone cortices.

(2) Mild mature red blood cells have mild morphological changes, red blood cell osmotic fragility is normal or decreased, and hemoglobin electrophoresis shows an increased HbA2 content (0.035-0.060), which is the characteristic of this type. HbF content is normal.

(3) Intermediate changes in peripheral blood and bone marrow images, such as severe cases, decreased red blood cell osmotic fragility, HbF content of 0.40-0.80, and normal or increased HbA2 content.

2. α-globin deficiency anemia (thalassemia)

(1) The morphology of resting red blood cells is normal. The Hb Bart's content in the umbilical cord blood is 0.01-0.02 at birth, but disappears after 3 months.

(2) Mild type: Slight changes in red blood cell morphology, such as unequal size, central light staining, and abnormal shape; reduced osmotic fragility of red blood cells; positive denatured globin bodies; normal or slightly low levels of HbA2 and HbF. The Hb Bart's level in the cord blood of the infants was 0.034-0.140 and completely disappeared at 6 months of age.

(3) Intermediate type: Changes in peripheral blood and bone marrow are similar to those of severe β-thalassemia; erythrocyte osmotic fragility is reduced; denatured globin bodies are positive; and HbA2 and HbF levels are normal. At birth, the blood contains about 0.25 Hb Bart's and a small amount of HbH; with age, HbH gradually replaces HbBart's, and its content is 0.024-0.44. The inclusion body formation test was positive.

(4) Severe changes in the morphology of mature red blood cells in peripheral blood, such as severe β-thalassemia, with a significant increase in the nucleated red blood cell count and reticulocyte count. Hemoglobin is almost entirely Hb Bart's, or contains a small amount of HbH, but no HbA, HbA2, or HbF.

This article will stop here to introduce how to check and diagnose thalassemia. In fact, thalassemia is not common in northern my country, but it is very common in Guangdong. This has a lot to do with the eating habits in Guangdong. So if you want to improve thalassemia, please first improve your eating habits.