Patient: Description of condition (onset, main symptoms, hospital visited, etc.): Patient male, 19 years old, in June 2009 urine was orange, and the sclera of the eyes yellow, total bilirubin more than 90, no other physical sensation. June 2010 is still the above symptoms, Yantai Hospital, hospitalized for a week, untreated bilirubin down to 34, was diagnosed as hemolytic jaundice. in September, bilirubin rose again to 78. in October Other results are as follows: Acid hemolysis + sugar water: negative results Kidney complete + liver complete: test results reference range Albumin Total bilirubin Direct bilirubin Other are within normal range Blood routine + reticulocytes: test results reference range Lymphocyte percentage Single cell hemoglobin Other are within normal range Abnormal cells: test results reference range Neutrophil percentage Plasma free hemoglobin: Laboratory results Reference range Plasma free Hb 20.5 ≤ Urine routine + flow urine sediment analysis: Laboratory results Reference range Specific gravity Urine bilinogen Other normal Urine ferritin test: negative Anti-human globulin test + typing: All negative Laboratory results Reference range Blood sedimentation: All negative Anti-nuclear antibody profile 3: All negative results Leukocyte morphology graphic report: Laboratory results Normal values Neutral rods Neutral lobes Lymphocytes Monocytes Eosinophils Basophils Erythrocyte morphology is approximately normal Leukocyte morphology is approximately normal Platelet count and morphology is approximately normal Nucleated erythrocytes 0/100 leukocytes The above results were diagnosed as hereditary spherocytosis. She has not had any treatment since the onset of the disease, and her doctor has recommended that no treatment is necessary. Could the above symptoms be “paroxysmal sleep hemoglobinuria”? Thank you for your answer! What should I do if I have “hereditary spherocytosis” as described above? Will there be any other problems if I don’t treat it? Do I need to pay attention to any problems in life and diet? Dr. Hao: It is not paroxysmal hemoglobinuria, if the diagnosis of HS is confirmed, the treatment plan will be decided according to the condition. HS is a congenital hereditary hemolytic anemia, in general, if the anemia is not very severe, no special treatment can be given. Considering that the patient has a large spleen, most of the red blood cells will be destroyed in the spleen, therefore, it is recommended to perform a splenectomy, and some of the patients can get significant relief from the symptoms. Thank you Patient: Thank you very much Patient: Hello Dr. Hao: Thank you very much for your reply! Currently, my child’s symptoms are large liver, large spleen, bilirubin around 70, yellow sclera, and orange morning urine. If I don’t treat it now, will it affect my health? Will it progress to other diseases? The child has no physical discomfort now and is not anemic, so why should he wait until the anemia is more severe or even affects his normal life before he needs treatment? Wouldn’t early removal of the spleen be beneficial to the body sooner? Is there no need for treatment if there is no anemia permanently? My child is now away at college and I am very nervous about his condition, so I hope you can give me a detailed answer. Thanks again! Patient: Dr. Hao, my child gets motion sickness and takes Chafenac tablets every time he rides in the car. Thank you! The child is still young, only 19 years old. It is generally recommended not to remove the spleen under the age of 20 because of the possibility of fulminant infection. Therefore, if there is no anemia, or if the symptoms of anemia are not severe, it is recommended not to remove the spleen for the time being. Therefore, if you do not have anemia, or if your anemia is not severe, it is recommended that you do not remove the spleen for now.