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Dr. Abid
Dr. Abid, Doctor
Category: Medical
Satisfied Customers: 5838
Experience:  MBBS, FCPS(R)
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My nine year old has a hemoglobin count of 6.9 which is condsider

Customer Question

My nine year old has a hemoglobin count of 6.9 which is condsidered extremely low. His lead levels, white blood cells, plateletts, and reticulicites(?) are normal. What could be wrong?
Submitted: 6 years ago.
Category: Medical
Expert:  Dr. Abid replied 6 years ago.

Well come to JUST ANSWER.

Regarding your question i want to share with you that as you mentioned your child have low level of hemoglobin and rest of the cell count and retic count are normal some time iron deficency in childrens can present with low level of hemoglobin as iron is necessary for the foramtion of hemoglobin so ge check iron level and total iron binding capacity and if levels are low then replace your child iron accoringly .


Customer: replied 6 years ago.

I would like to add that he suffers from nose bleeds. In June he had a severe nose bleed which caused him to almost pass out. Could this recent episode be the cause of the 6.9 reading?
If his body is lacking hemoglobin and his red blood cells are 'small' according to a recent blood test, why isn't his retic counts higher indicating that his body is trying to make it up?

What methods of iron replacement do you suggest?

Expert:  Dr. Abid replied 6 years ago.

As you mentioned that he had nose bleed and recent blood test showed small red blood cells mean microcytic cells are these cells are seen usually in iron defeciency anemia commonly called microcytic ,hypochromic anemia,i will suggest him fresh apple juice that is rich in iron twice a day , along with iron syrup three times a day one teaspoonful and continue this treatment for 2 -3 months he will improve.


Customer: replied 6 years ago.
Iron rich apple juice! Wow. We can do that with ease. Okay... one last question... what are your thoughts on the 'normal' reticulicites, yet his hemoglobin being low??
Customer: replied 6 years ago.
Why isn't his retic count higher if the hemoglobin is low?
Expert:  Dr. Abid replied 6 years ago.

Well retic can be normal in different types of anemia such as in vitamin B12 defeciency and other type of anemia so dont worry for that and start his treatment.


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Customer: replied 6 years ago.

There was also a mention of broken fragments in the redblood cells.... what does that mean?

Expert:  Dr. Abid replied 6 years ago.

I will finally suggest you to please get once consultation from hematologist and discuss all the report parameters with him that will also helpful for you.


Customer: replied 6 years ago.
An appointment is currently being scheduled with his pediatrician, however, I was hoping that you would be able to provide me with a more immediate answer.
Expert:  Dr. Abid replied 6 years ago.

Well broken fragments in the red blood cells or such fragmented RBC's are known as schistocytes and they are indicative of a hemolysis or breakdown of red blood cells.