What Causes Anemia?
Discussion
One of the most common problems in pediatrics is anemia. It is defined as “a lower than normal value for the related measurements of hemoglobin, hematocrit, and number of red blood cells”, usually 2 standard deviations below the normal for age. Normal hematological values change with age. For a discussion of which values are used click here.
The most common type of anemia in childhood is iron deficiency which is commonly caused by inadequate stores (e.g. premature infant), inadequate intake (e.g. poor nutrition) or blood loss (e.g. menses). Anemia screening is recommended at age 9-12 months, and for adolescent males and females during routine health examinations. As iron deficiency is the most common cause, often a trial of therapeutic iron (2-6 mg/kg/day of elemental iron) is started and then a complete blood count is rechecked ~ 1 month later. If iron deficiency is the cause then there should be an increase in the hemoglobin and hematocrit. If not, other causes must be sought. For a discussion of why anemias may not correct click here.
History is very important to help direct the evaluation and workup. A detailed dietary history including pica or lead ingestion can give clues to a possible dietary reason for the anemia, especially iron deficiency anemia. Blood loss history including trauma, bleeding or potential occult loss from the genitourinary tract are also very helpful. Bone marrow production problems (e.g. malignancy, infectious diseases) or h...
Source: PediatricEducation.org - Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
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