Hemoglobin Disorders

Anemia is common in immigrants from Asia, Southeast Asia (Vietnam, Laos, Cambodia), and South Asia (India, Pakistan). The majority of the blood cell (RBC) disorders are not associated with clinical significant disease. However, some may cause intrauterine fetal demise or chronic hemolytic anemia requiring lifelong RBC transfusions (Glader and Look 1996).

By far, the most common cause of anemia in Asian immigrants is iron deficiency. One large study of Southeast Asian children who had recently emigrated to the US found that 48% of Cambodian children, 19% of Laotian children, and 24% of Vietnamese children demonstrated anemia. Dietary habits and parasites were the most common culprits. In 37% of children, stool analysis identified hookworm (Hurst et al. 1983).

It is becoming increasingly apparent that a significant proportion of Asian immigrants may have a hemoglobinopathy. One study of Southeast Asian refugees found that 40% had evidence of at least one major red blood cell abnormality: 22% had glucose-6-phosphate dehydrogenase deficiency, 16% had hemoglobin E disease, 6% had alpha-thalassemia, and 4% had beta-thalassemia (Glader and Look 1996).

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