Hemoglobin D/B+ Compound Heterozygote With Autoimmune Hemolytic Anemia

A 10 years old child presented with progressive pallor since birth and history of jaundice and abdominal distension since 4 months.investigations revealed a positive direct antiglobulin test and a diagnosis of autoimmune hemolytic anemia was made.steroids were given and patient responded to it as evidenced by laboratory investigations returning to normals and alleviation of jaundice,but clinically pallor persisted. hemoglobin electrophoresis performed by hplc(high performance liquid chromatography) revealed a significant percentage of hb d and a2, suggestive of hbd/b+ trait that was later confirmed by parents’ screening.sickling test was performed that turned out to be negative