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Anemia is the reduction in the hemoglobin concentration, hematocrit, or the number of red blood cells (RBC). Any child with hemoglobin (Hb less than 11 gm/dl is defined as anemic.
The primary function of Hb/ red blood cells is to deliver adequate quantities of oxygen from the lungs to other body tissues.
Symptoms -
An Anaemic person will have less oxygen in the blood and tissues which leads to-- Tiredness, Fatigue
- Shortness of breath
- Headache, dizziness
- Muscle pain
- Hair loss
- Lower the resistance to fight infection- repeated infections
- Poor concentration, poor memory, and learning difficulties
- Irritability, mood changes
Causes
Common causes of anemia in children are Iron deficiency anemia, Thalassemia, sickle cell anemia, infections, cancers, and aplastic anemia.
Hb/RBC Can Be Low Due To
Decreased Production
- Nutritional cause (IDA, Vitamin B12 & Folate deficiency)
- Aplastic anemia ( Bone marrow Failure Syndrome)
- Bone marrow infiltration- Cancer
Increased Destruction
-
Hemolytic Anemias-
- Intracorpascular: Thalassemia, Sickle cell anemia, Red cell enzyme defect or membrane defect
- Extracorpuscular: Autoimmune Hemolytic anemia Drugs Infections
Blood Loss
- Stomach Ulcers
- Hemorrhoides
- Heavy or irregular menstruation
- Trauma
- Surgery
- Cancer
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Iron deficiency anemia can lead to poor physical growth, repeated intestinal and respiratory infections, impaired cognitive and psychomotor skills, and behavioral changes. Excessive intake of milk can also cause iron deficiency anemia in children.
- Diagnosis: A detailed history, including dietary history, family history, physical examination, and blood investigations are required to diagnose the type of anemia.
- Initial blood investigations include Complete blood counts (CBC) and peripheral blood smears. Based on these reports we can broadly categorize the type of anemia and then we can proceed with further specific tests
Other specific and relevant tests:
- Serum iron studies, serum ferritin
- HPCL
- Vitamin B12 or Folate levels
- Reticulocyte count
- Bone marrow examination
- Stool routine examination and for occult blood
- DCT, LDH, haptoglobin, and Liver function test in case of hemolytic anemia
Treatment: Treatment will depend on the type of anemia.
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Iron deficiency anemia (IDA) is treated with an oral iron supplement and nutritional and dietary guidance. Sometimes intravenous iron injections are given in some cases where oral iron is contraindicated.
Thalassemia major: These children need regular blood transfusions and iron chelation therapy. The curative treatment option is Bone Marrow Transplantation.
Aplastic anemia: Bone marrow transplant is the curative option. But in case a bone marrow transplant is not possible then the patient can be treated with immunosuppressive therapy.
In acute hemolytic anemia, we need to treat the underlying cause. In G6 PD deficiency, the child needs to avoid certain drugs to prevent the breakdown of red cells.
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