Snap Shot A 22-year-old Vietnamese female presents for a routine gyn exam. Her menstrual cycle is normal and there is no evidence of other bleeding. Guiac is negative. Her hemoglobin is at 11 (12-16), RBC is 5.8 (3.5-5.5), and an MCV of 70 (80-100) with a normal RDW of 10. WBC and platelets are normal. Hemoglobin electrophoresis shows an increase in amount of Hgb A2 and Hgb F. Introduction Hereditary disease caused by decreased production of hemoglobin chains Most common cause of microcytic anemia in Asian Americans and African Americans There are four alpha genes and two beta genes that make up three forms of hemoglobin (Hgb) login to view 1 more bullet STUDIES Ratio used: login to view 3 more bullets Lab findings login to view 6 more bullets DIAGNOSIS Forms of disease diagnosed through gel-electrophoresis of globin chains Unexplained finding is that although there is a decrease in the Hgb concentration and MCV, there is a normal or slightly increased RBC count Alpha Thalassemia Due to a decrease in alpha globin chain production Seen commonly in Asians login to view 2 more bullets Beta Thalassemia Beta thalasemia is more common in people of Mediterranean or African origin Function of beta chain required at six months when switch from fetal y Hgb to adult beta Hgb occurs login to view 1 more bullet