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Begin with simple grip holds using minimal resistance

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DNA testing required for formal diagnosis (not a first-line investigation, exclude other causes first) Pre-pregnancy carrier testing of partner is important Rare causes of microcytic anaemia Chronic inflammation Lead poisoning (high blood lead level) Sideroblastic anaemia Normocytic normochromic anaemia Haemolytic anaemia Acute haemolysis in childhood can be a life-threatening illness and all cases should be discussed with a haematologist Admit children with haemolytic anaemia for observation