3 yo male with history of prenatal anemia requiring RBC transfusion presented with chronic microcytic anemia. Mother also has anemia. CBC: Hb 7.8, HCT29.6, MCV 75.9, MCH 20, RBC 3.9M/ul,RET 8.5%, WBC 9.42, Neut 5.38, Lym 3.23, mon 0.53, plt 870 K/ul.
Peripheral blood shows findings as below.
Peripheral blood shows findings as below.
Capillary Hemogblobin electrophoresis:
HPLC: