Contributed by Franklin Sedarat MD, MSc and Dmitriy W. Gutkin MD, PhD
Published on line in March 2006
This is a patient with chronic normocytic normochromic anemia in the range of 8 to 10 g/dl. Further testing included Iron, TIBC, folate and B12 which were within normal range. Reticulocyte count was increased. Peripheral blood smear showed many target cells, nRBC and polychromasia.
Figure 1: What is this (peripheral blood smear - arrow)?
Figure 2: Hemoglobin electrophoresis was done. The following panel shows the results of Hb electrophoresis performed on alkaline gel (1: normal, 2: AFSC control, 3: patient). Can you make a definite diagnosis? What do you do next?
Figure 3: The following panel shows Hb electrophoresis performed on acidic gel ( 1: normal, 2: AFSC control, 3: patient). Can you make a definite diagnosis now? Which band does not match the diagnosis? What other piece of clinical information you need to know?