A 54-year-old female patient had been diagnosed with anemia for 1 year and was treated with Yiqi Weixue Capsules without effect. Three days ago

she developed fever (maximum 39 ℃)

nausea and vomiting with blood streaks

and upper abdominal pain without obvious inducement

accompanied by palpitation

chest tightness

frequent urination and dysuria

and was admitted to our hospital. Routine blood test showed severe microcytic hypochromic anemia

abnormal ratio of red blood cell count to hemoglobin

and tailing of platelet histogram. Biochemical examination showed normal serum iron and elevated ferritin

excluding iron deficiency anemia. Target cells and teardrop cells were found by peripheral blood smear microscopy. Combined with the patient's Guangxi origin and family history of anemia

RBC×100/MCV and Mentzer index were calculated to screen for thalassemia. Finally

she was diagnosed with α combined β thalassemia by thalassemia gene detection

and her daughter was also detected with α thalassemia gene mutation. At present

the patient has been transferred to the specialist department for targeted treatment.