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help needed please !!!!

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kabir_love:

--- Quote from: kabir_love on February 27, 2009, 05:57:17 AM ---thx zaini i was having problem with 2 post cauz cant upload more then 5 reports together thats y.
thx
attached our and our son mutations reports aswell.


--- End quote ---

Zaini:
Micky,

The report indicates clearly that your daughter is a thal minor,so what Andy said makes complete sense.


--- Quote --- To be honest, thalassemia alone would make no sense for this reaction. It could possibly be thal minor combined with another factor.
--- End quote ---

Doctors need to find this other factor.

Zaini.

Andy Battaglia:
Mickey,

Please make sure that the Rh factor has been considered and also the second possibility in bold below. Are bilirubin levels and reticulocyte higher than normal? This may not be related to thalassemia at all and determining why hyperhemolysis has been taking place is most important. Even a thal major would not have this severe condition at this age. Has there been a Coombs test? Has an exchange transfusion been considered?

http://wo-pub2.med.cornell.edu/cgi-bin/WebObjects/PublicA.woa/1/wa/viewHContent?website=wmc+pediatrics&contentID=2368&wosid=9JvrhOwEKQQPce3AcKttjw
   

--- Quote ---What causes hemolytic disease of the newborn (HDN)?
   HDN most frequently occurs when an Rh negative mother has a baby with an Rh positive father. When the baby's Rh factor is positive, like the father's, problems can develop if the baby's red blood cells cross to the Rh negative mother. This usually happens at delivery when the placenta detaches. However, it may also happen anytime blood cells of the two circulations mix, such as during a miscarriage or abortion, with a fall, or during an invasive prenatal testing procedure (i.e., an amniocentesis or chorionic villus sampling).

The mother's immune system sees the baby's Rh positive red blood cells as "foreign." Just as when bacteria invade the body, the immune system responds by developing antibodies to fight and destroy these foreign cells. The mother's immune system then keeps the antibodies in case the foreign cells appear again, even in a future pregnancy. The mother is now "Rh sensitized."

Although it is not as common, a similar problem of incompatibility may happen between the blood types (A, B, O, AB) of the mother and baby in the following situations:

   

Mother's Blood Type               Baby's Blood Type
   

O                                            A or B
   

A                                           B
   

B                                          A
   
In a first pregnancy, Rh sensitization is not likely. Usually it only becomes a problem in a future pregnancy with another Rh positive baby. During that pregnancy, the mother's antibodies cross the placenta to fight the Rh positive cells in the baby's body. As the antibodies destroy the red blood cells, the baby can become sick. This is called erythroblastosis fetalis during pregnancy. In the newborn, the condition is called hemolytic disease of the newborn.
--- End quote ---

kabir_love:
hi andy
we had done rh factor test we both parents are b+  and our baby also b+ also we had done rh antigen test done they are also ok. done and confirmed ... also
mycopalsma is negative.
DCT test negative.

now doctors are thinking of doing  liver biopsy. dont know what they are thinking of.

AS PER ANDY SAID WE CHECKED WITH DOCTOR

PAROVIRUS - NEGATIVE
MYCOPLASAMA - NEGATIVE
TORCH - ALL NEGAVTIVE
HIV - NEGATIVE
LDH - HIGH (254)
D DIMER- NORMAL
CULTURE STERLIE
ERYTHROID SERIES - NORMAL
MEGAKARYOCYTES - ADEQUATE
PLATLETS - 1.50 ( TO MUCH UPS AND DOWN .50 TO 1.50 )
NO AVIDENCE OF HYDROCEPHALUS AND HEMMORRHAGE IS SEEN IN LIVER , SLPEEN AND STOMACH.
CYTOMEGALO VIRUS (CMV) - NEGATIVE.
HSV - NEGATIVE
TANDEM MASS SPECTROMETRY (AMINO ACID,ORGANIC ACID, FATTY ACID, METABOLISIM  ALL NORMAL)
HBF- 70%, HBA2- 26% ( DONE AT 35 DAYS OF BIRTH)
HYPO THAROIDISM - NORMAL
TITRE OF INCOMPLETE ANTIBODIES - NEGATIVE
DIRECT ANTI HUMAN GLOBLIN TEST - NEGATIVE
RH FACTOR - NORMAL.
RH ANTIBODIES - NORMAL.
HDN TEST - NORMAL.

Kell system antibodies - TEST NOT DONE
Duffy system antibodies - TEST NOT DONE

Sharmin:
Mickey,

I am praying that your daughter will be fine.  It must be so difficult having your newborn go through so many tests.  I hope that they diagnose her condition and resolve it very soon. 

Sharmin

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