Question

A 12-month-old girl is in the clinic for a well-child check. She can walk and is eating more table foods. The parents have given her goat's milk for two months. Physical examination is normal. Laboratory screening obtained shows hemoglobin of 10 g/dL, mean corpuscular volume 77 fL, and elevated red cell distribution width. Which of the following is the most likely diagnosis?

a. Iron deficiency anemia
b. Vitamin B12 deficiency
c. Folate deficiency
d. Thalassemia

Answer 1

For the 12-month-old girl with a low hemoglobin level, microcytic red blood cells, and elevated RDW, the most likely diagnosis is iron deficiency anemia, likely due to the prolonged consumption of goat's milk, which is low in iron.

Step-by-step explanation:

The most likely diagnosis for the 12-month-old girl with a hemoglobin of 10 g/dL, mean corpuscular volume (MCV) of 77 fL, and elevated red cell distribution width (RDW) after being given goat's milk for two months is iron deficiency anemia. This condition is highly prevalent among children and can be indicated by low levels of hemoglobin within the range of 5 to 9 g/100 ml, which is consistent with the presented case. The history of feeding the child goat's milk is significant because goat's milk is known to be low in iron, contributing to deficiency, especially in rapidly growing infants who have increased iron requirements.

Iron deficiency anemia can result in developmental delays and growth re_tardation. It is characterized by microcytic and hypochromic red blood cells, which is consistent with the MCV being low (microcytosis) and can be distinguished from other types of anemia by these red blood cell features. Treatment would include addressing the iron deficiency through dietary changes and potentially iron supplementation under medical guidance.