Michael is a 2-month-old male born to parents who recently moved to the Louisville area for work from rural California. His mother had most of her prenatal care in their prior state and did not seek prenatal care prior to delivery of Michael in the local hospital. She stated she was full term at delivery and that she had not had any complications detected in her prior prenatal care course. He is their first baby, although she had a second trimester fetal demise the year prior to getting pregnant with Michael. She took no medications during pregnancy other that prenatal vitamins.
Michael is following up in the Pediatric Hematology office after his primary care doctor told his parents that his newborn screen returned with an abnormal result for hemoglobinopathies at his 2-week clinic follow-up visit. The parents were given an order for additional blood work at the time that the follow-up visit with the specialist was scheduled. The primary care called the Pediatric Hematology physician on call at the time of making the appointment to warn her that the parents are Jehovah’s Witness and have already stated they will not allow blood transfusions for Michael when they were told that he may have a blood disorder.
Michael was placed on prophylactic penicillin by his primary care doctor at the advice of the Pediatric Hematologist during the first month of life while awaiting his formal hematology evaluation. He had prolonged neonatal jaundice for the first 2 weeks of life that was treated with home UV light blankets and followed with serial lab draws. This jaundice was initially attributed to breastfeeding, but his parents were then told that it may be due to his blood problem. He has since been growing and feeding well, without any unusual problems. Both parents are well and deny any known problems with blood in the family.
His physical exam is normal for his age, and his lab results as well as hemoglobin electrophoresis ordered on his mother are attached below for your review.