A 12-year-old with a family history of thalassemia has a normal CBC. What additional test should be ordered?

In the case of a 12-year-old with a family history of thalassemia and a normal complete blood count (CBC), ordering a hemoglobin electrophoresis test is appropriate for several reasons. Thalassemia often presents with microcytic anemia, but it is possible for an individual, especially one who may be a carrier or has a milder form of the condition, to have a normal CBC while still harboring thalassemia traits.

Hemoglobin electrophoresis is a specialized test that separates different types of hemoglobin based on their electrical charge and can identify abnormal hemoglobin variants that are characteristic of thalassemia. By measuring the proportions of different types of hemoglobin, this test can confirm a diagnosis of thalassemia or identify if the child is a carrier of the trait, despite the normal CBC findings.

In contrast, checking serum folic acid or vitamin B12 levels could be relevant in evaluating macrocytic anemia but are not specifically aimed at detecting thalassemia. A 24-hour urine creatinine test is typically used to assess kidney function and does not provide any information relevant to diagnosing or ruling out thalassemia. Therefore, the most informative and relevant test in this scenario is hem