儿童地中海贫血误诊四例分析

Thalassemia misdiagnosed as iron deficiency anemia:analysis of four cases

目的分析4例地中海贫血误诊漏诊的原因,为正确诊治提供经验。方法回顾性分析我院4例地中海贫血患儿的诊治过程,分析其误诊漏诊的原因,并与营养性缺铁性贫血进行鉴别。结果4例患儿病初诊断为营养性缺铁性贫血,予补铁治疗后血红蛋白无改善,最终3例确诊为β-地中海贫血,1例确诊为营养性缺铁性贫血合并α-地中海贫血。结论地中海贫血在低发地区容易误诊漏诊,尤其当小细胞低色素性贫血补铁治疗不佳时,需警惕是否存在地中海贫血。

Objective To analyze the causes of misdiagnosis of thalassemia to improve its recognition and accurate diagnosis.Methods The clinical manifestations of four cases of thalassemia were retrospectively analyzed,and the difference between thalassemia and iron deficiency anemia was explored.Results All four cases were diagnosed as iron deficiency anemia initially.After iron supplementation was ineffective,three cases was finally diagnosed as β-thalassemia and one as iron deficiency anemia combined with α-thalassemia.Conclusion Thalassemia is easy to be misdiagnosed clinically.When the treatment of iron supplementation for microcytic hypochromic anemia is ineffective,the possibility of thalassemia should be considered.