Discussion Forums > Thalassemia Major

Poor Appetite after Transfusion

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Anubha:
Hello,

I am Anubha from India. My 5 year old daughter was diagnosed as a Thal Major when she was 3 months. Till April this year she was maintaining a Hb of 7.5 - 8 and so wasn't advised transfusions earlier. We were thinking she might be a Thal Intermedia than a Major. But in April as she was developing a fever on and off we got her Hb tested and it was quite low 5. She was advised transfusion immediately. Since then she has been transfused 4 times, but her Hb is not getting maintained. Yesterday she was again transfused, but she is still looking pale and has a poor appetite. In her earlier transfusions we could see a remarkable visible difference from her face and eyes. This time it is not as earlier.
We will again get her Hb tested day after tomorrow.
Any suggestions or advise.

Himanshu Kumar:
Pls specify the quantity of blood transfused in each occasion. Whats her weight.

Canadian_Family:
If she is transfused regularly and maintains Hb of 10 or above then it is just a matter of time when she gets back to normal. I don't think there is too much worry here, children will eat when they feel like it. I would make sure she is transfused well.

Also, it is very common mistake for parents to look for symptoms such as paleness to determine if their Hb is normal, this is not an indicator, sometimes a child looks pale but the Hb is normal. Only a valid Hb test can determine if Hb is normal.

Sharmin:
Anubha,

I agree with Canadian Family, your child needs hypertransfusion - maintaining a hemoglobin above 9.5 will normalize your child's hemoglobin.   It takes several transfusions to build up the hemoglobin, if your child's starting point was 5, the transfusion may have brought it to 8.5 or 9 - if you repeat the transfusion 1 week later your child's hemoglobin level will build to be above 10.   

If your child has had a low hemoglobin for many years the spleen may also be big, it will take time for hypertransfusions to shrink the spleen.  An enlarged spleen breaks down red blood cells at a quicker rate. 

Low appetite is generally associated with low hemoglobin, but as Canadian_Family has said only a blood test can give an accurate picture of your child's levels.

Best of luck,

Sharmin

Andy Battaglia:
I agree with the others. The Hb needs to be brought up to a higher level and kept there. Your child will not grow and develop properly with low Hb.

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