Case 125 – update 1

Our lady who is 8 weeks pregnant and feeling a little tired and sickly has a microcytic anaemia. You suggested that the most likely cause of the anaemia is iron deficiency but that we couldn’t rule out a haemoglobinopathy with the information currently available.

You suggested a trial of oral iron replacement  – we have had a few different dosages suggested.  You also advised her to start taking folic acid supplements to reduce the likelihood of neural tube defects in the baby.

Some of you mentioned the importance of checking ethnicity of the lady and her partner as well as any personal or family history of haemoglobinopathy. Her family origin questionnaire completed at her booking appointment shows that she and her partner are white and from the UK, as were her and the baby’s father’s parents.

Her blood film and HPLC are shown here:imageimage-2

Questions:

  • Any comments on the film?
  • Any comments on the HPLC?
  • What dosing regime would you use for her iron replacement and why?
  • When would you next check her blood count?

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