![]() ![]() Physiological trough at 2 3 month of age Dramatic reduction in erythropoiesis after birth Rapid growth in early infancy Very high level at birth Relative hypoxemia in fetal life Physiological changes in red cell indices (Hb,Hct,RBC) with age Venous blood preferred Adequate volume of bloodĪnemia is functionally defined as an insufficiency in RBC mass to adequately deliver oxygen to peripheral tissueįor practical purpose anemia is defined by a laboratory value 2 SD below the mean for normal population in any 1 of the 3 red cell indices: haemoglobin level (Hb), haematocrit (Hct) or Pallor can be due to True anemia Vasoconstriction Fair colorĬompare childs Hb/Hct with normal values for age & sex Non-specific symptoms Irritability Poor sleep quality Anorexia Poor concentration, school work Failure to thriveĭizziness / syncope Malaise, easy fatigue, impaired exerciseġ) Is the child truly anemic?2) Histor圓) Physical examination4) RBC indices & peripheral blood smear5) Reticulocyte count6) Other appropriate investigations ![]() Symptomatology and etiology of anemia in children Thalassemia, spherocytosis, G6PD orpyruvate kinase deficiencyĢ. Defects of Hb, RBC membrane or metabolism Abnormal nuclear maturationB12 or folate deficiency, inborn or druginduced disorders of DNA synthesisģ. ![]() Iron deficiency, thalassemia,sideroblastic anemia, lead poisoningĢ. Disorder of maturation & ineffective erythropoiesis1. Impaired erythropoietin productionChronic renal failure,Hypothyroidism,Hypopituitarism, Chronic inflammation,MalnutritionĬ. ![]() AcquiredIdiopathic, infection, drug,malignant infiltration,myelofibrosis, chronic renaldiseaseĢ. Hereditary/constitutionalįanconi anemiaDiamond-Blackfan anemiaDyskeratosis congenitaOsteopetrosisetcī. Transient erythroblastopenia of childhood (TEC)Įffective Effective erythropoeisiserythropoeisis Intrinsic ability (normal RBC precursors) It may cause a dramatic fall in Hb in patients who have chronic haemolysis with a shortened red cell survival aplastic crisis. Useful facts of childhood anemia7) Worldwide, Fe deficiency is probably the mostĬommon cause of isolated anemia especially in children aged 1-5 years.Ĩ) In a patient with thalassaemia trait & concomitant Fe deficiency, HbA2 level can be normal as Fe deficiency depresses globin synthesis Hbelectrophoresis should be repeated after Fe deficiency is corrected.ĩ) A group of anemias unique to childhood is aregenerative anemia and constitutional aplasticanemias.ġ0) Parvovirus is unique in its erythrotropicnature & striking affinity for erythroidprecursors and produces transient erythroid marrow aplasia. Department of Paediatrics & Adolescent MedicinePrincess Margaret Hospitalġ) In interpretation of laboratory haematological values, age and sex has to be taken into consideration.Ģ) Reticulocyte count is very often not included in the CBC.ģ) Macrocytic anemia is rare in childhood.Ĥ) In macrocytosis, it is prudent to determine if the MCV is due to reticulocytosis.ĥ) Many childhood anemias have a hereditary basis.Ħ) Nutritional deficiency is extremely rare in infants who are fed on commercial formula or breastfed by mothers with an adequate diet or taking supplement. ![]()
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