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Paleness

Question
Dear expert team,

My daughter is 8 years old and has CF (F508 del homozygous).

Her oxygen saturation and lung function are good, and everything else has also been okay so far. She is very pale, so that after a picture was taken of her recently, she said she looked like a vampire. What can I do so that she picks up some colour? I pay very close attention to her diet.

Many thanks in advance for your answer.
Answer
Hello,

The paleness can have several causes. On the one hand, it can be hereditary; on the other, it can be a symptom of a serious illness or a deficiency.

If lung function is low, dyspnoea/hypoxia could cause the paleness. However, you preclude this by stating that your daughter’s lung function is good.

Vitamin B12 and folic acid deficiency could also cause abnormal paleness: In case your daughter had intestinal surgery for meconium ileus, and with a lack of vitamin B12 supplementation (by intramuscular injection), she could develop a vitamin B12 deficiency over time. Like vitamin B12 deficiency, folic acid deficiency also leads to anaemia, which manifests itself, in paleness, among other things. A further cause could be omeprazole, which can interfere with the vitamin B12 assimilation and therefore result in a deficiency or anaemia.

You should also test your daughter for gastrointestinal bleeding. Here, a stool sample is tested for “occult” blood.

These are only some potential causes of paleness; you should therefore definitely have a (CF) doctor examine your daughter.

Kind regards,
Suzanne van Dullemen
22.10.2013