Marcus is a 5-year-old African-American male who has just moved to New York City, and is visiting his new pediatrician for a kindergarten physical. His mom tells the nurse that she carries the “trait” and wants Marcus screened for it.

Marcus may have Sickle Cell Anemia. Sickle Cell Anemia is a genetic disorder that occurs when a child inherits two sickle hemoglobin genes, one from each parent. Sickle cell is not contagious, and you must be born with it. Normal red blood cells are round and flexible, while people with the Sickle Cell disease have blood cells that are crescent shaped. The Sickle-shaped red blood cells break apart easily, and do not live as long as normal red blood cells. Damaged red blood cells tend to clump together and stick to the walls of blood vessels blocking the flow of blood through the body. These damaged blood cells also cause the person to experience severe pain, and they may not know why they are in pain. All newborns must be tested for sickle cell disease. The sickle Cell disease is diagnosed by a blood test called hemoglobin electrophoresis. The sickle shaped blood cells can be seen in a blood sample under a microscope. The amount of sickle cells determines whether a person is a carrier of the trait, or has sickle cell disease. People with the Sickle Cell disease may take pain medication, anti-inflammatory medications, antibiotics, oxygen, and even intravenous or oral fluids. Those who have severe anemia, at risk for a stroke, or going in for surgery often receive blood transfusions. Stem cell transplants have a 5%-10% risk of death, but most patients have a complete cure of sickle cell disease with no further episodes of pain.

Amy, a 4-year-old Caucasian female, has been complaining of being tired all the time. She is pale and a picky eater. Her mother is a single mom with a small budget to feed a large family. Amy only eats pasta, breads, and hot dogs, and drinks only artificial fruit punch. (Vitamin B12 deficiency anemia,)

Amy may have Vitamin B12 deficiency anemia. Vitamin B12 is essential for normal nervous system function and blood cell production Vitamin B12 deficiency anemia occurs from a poor diet that lacks meat, eggs, dairy products, and fresh fruit and vegetables. Without vitamin B12 and intrinsic factor, immature red blood cells rupture easily within the chemical environment of the blood stream. The result is fewer than normal red blood cells and consequently a reduced oxygen-carrying capacity. A physical evaluation may be done to see if the patient shows any signs of neurological problems. A CBC test may also