Transcription
Let's talk about lab results in thalassemia. As you know, if you'll seem anemic, you're tired and pale, and exercise intolerant. Thalassemia is common in Italy, Greece, and the Mediterranean Sea. Okay, let's get started. Okay.
What results in alpha-thalassemia? Those symptoms are anemia, low hemoglobin, and hematocrit. However, in thalassemia, the RBC count is increased. Why? As we said before, nobody knows. So, the RBC count is high, and nobody knows why. Mean corpuscular index is less than 13. What's the mean corpuscular index? You have to go to the previous video. You will find occasionally, not consistently, some target cells and some teardrop cells.
Okay, lab results in alpha-thalassemia: anemia, low hemoglobin, and hematocrit. RBC count is high, and nobody knows why, as we said before. Thalassemia has normal to high RBC count. Mean corpuscular index is less than 13. What's the mean corpuscular index? You gotta go to the previous video. Okay. Occasionally, you will find target cells and teardrop cells, but they are not consistent in alpha-thalassemia. Why teardrop cells? Because you have some crazy macrophages okay, eating parts of the RBC, leading to the teardrop cells. RDW is normal because it's a genetic problem, not a nutritional deficiency. RDW is normal. FEP, the free erythrocyte protoporphyrin, is normal because it's not a nutritional problem; it's a global problem.
What about hemoglobin electrophoresis? It depends. If we are talking about the alpha-thalassemia trait, the hemoglobin electrophoresis will be completely normal. However, if we are talking about three-gene deletions, hemoglobin H, you'll find hemoglobin H on electrophoresis. For four-gene deletions, we are talking about hemoglobin Bart disease; you'll find the hemoglobin Bart on the hemoglobin electrophoresis. So it depends, but usually, people's electrophoresis is normal because most of the cases are alpha-thalassemia trait.
How about beta-thalassemia minor? Again, low hemoglobin and hematocrit because it's anemia. In thalassemia, RBC count is normal to high, and nobody knows why. Again, target cells, teardrop cells, but here they are consistent in beta-thalassemia; they are consistent. Why teardrop cells? Because of the macrophage. RDW normal. How about iron studies? Normal. Free erythrocyte protoporphyrin normal. Hemoglobin electrophoresis okay, so the hemoglobin A will be decreased; however, hemoglobin A2 increased, and hemoglobin F increased.
Now the big one: beta-thalassemia major. Same thing: low hemoglobin and hematocrit, increased RBC count. Mean corpuscular index again less than 13 because it's thalassemia; more than 13 in iron deficiency anemia. RDW here is high. Why? Because there is hemolysis, so the bone marrow will try to produce new cells. Gradually, at the beginning, there'll be normal-sized cells, and they will begin to become microcytic, so RDW will start to increase due to increased variation, red cell distribution width. Iron studies normal. FEP normal. However, since there is hemolysis, we will get unconjugated hyperbilirubinemia. The protoporphyrin consistently. We will find target cells, teardrop cells. Increased reticulocytes can indicate the hemolysis. Bone marrow is trying to push harder and produce immature RBCs, baby red cells, known as reticulocytes. Howell-Jolly bodies are basophilic nuclear remnants inside the RBCs, immature cells. Nucleated RBCs are immature because normal RBCs do not have any nucleus.
What about the hemoglobin electrophoresis? Here, the hemoglobin A, it's not decreased; there is no hemoglobin A, nothing, none whatsoever. How about hemoglobin A2 increased, and hemoglobin F increased. So that's it for the lab results of thalassemia, and I'll see you in the next video. Please take care and subscribe.