Pediatric Hematology Referral Guidelines
Specializing in the diagnosis and management of hematological disorders, the Hematology practice at Valley Children’s provides consultations 24 hours a day. We provide care for a large pediatric patient population with hemophilia and other bleeding disorders, hypercoagulabilities, thalassemia and other hemoglobinopathies, iron deficiencies, Fanconi anemia, Diamond-Blackfan anemia and other bone marrow failure syndromes.
Our team performs outpatient blood, platelet and immune-globulin transfusions for our pediatric patients who require these regimens. Our federally funded Hemophilia Treatment Center – the only one in Central California – participates in the Centers for Disease Control and Prevention’s ongoing surveillance studies related to bleeding and clotting disorders.
Valley Children’s hematology specialists also collaborate with other expert hematologists nationwide to offer the newest treatments for thalassemia, sickle cell disease and iron overload.
Our hematology specialists are always available for consultations and urgent patient appointments.
Refer to Hematology
Refer to Hematology online through CareLink or our referral portal, or refer via fax.
Refer a patientHematology Office Numbers
Contact Pediatric Hematology via phone (559-353-5460) or fax (559-353-5095).
Contact a Physician Liaison
Physicians can reach a physician liaison for help with referrals or other questions by calling 559-353-7229.
The following guidelines may not apply to many individual patient situations. Please contact us any time at the numbers provided to discuss your case further.
| Group | Condition | Pre-Referral Work-up | When to Refer |
|---|---|---|---|
| Anemias | Iron deficiency |
Other key history: diet, blood loss Labs: CBC, retic, iron, TIBC, ferritin, lead |
Symptomatic and/or non-responsive to oral iron therapy |
| Hereditary spherocytosis |
Other key history: family history Osmotic fragility test Labs: CBC, retic, bilirubin |
Confirmed or suspected diagnosis of hereditary spherocytosis | |
| Sickle cell; Thalassemia | Labs: CBC, retic, bili, hemoglobin electrophoresis | Confirmed or suspected diagnosis of thalassemia and/or sickle cell anemia | |
| Other cytopenias | Thrombocytopenia | Labs: CBC | Platelet count below the normal range |
| Neutropenia | Labs: CBC, retic, manual neutrophil count, if available | Persistent ANC <1000 | |
| Bleeding disorders | Menorrhagia and / or Epistaxis and / or Easy Bruising | Labs: CBC, PT, PTT, von Willebrand factor Ag and activity, factor VIII activity | If labs abnormal, or bleeding / bruising significant even if labs are normal / not done |
| von Willebrand disease | Labs: PTT, platelet function analysis, von Willebrand factor Ag and activity and multimer analysis, factor VIII activity | Confirmed or suspected diagnosis of von Willebrand disease | |
| Hemophilia | Labs: PTT, factor VIII and / or IX activity | Confirmed or suspected diagnosis of hemophilia |