About 2 months back a mother with her 1 and half yr old child consulted me for pain abdomen due to ingestion of crayons one day back.As usual pallor is first of all searched and i clinically expected hb to be nearby 7 to 8.Hist didnt suggest any blood loss or very poor nutrition. Economically family was well to do.Apart of pallor all s/e was normal.No HSM was detected. While discussing with the mother i noticed mother to be icteric and on asking she narrated the whole history which clinched the diagnosis.
12 yrs back during her 1st pregnancy she was diagnosed to have severe anemia. hb was 6.5 and was referred to a physician.Blood transfusions were given and was referred to Vellore for further work up.Vellore doctors returned back and advised to reconsult them after 3 months as she was transfued few days back.Then she never got investigated either in Ranchi or Vellore or other…
