From the Research
Introduction to Anemia in Children
Anemia is a significant health concern in children, with various causes and consequences. According to 1, iron deficiency anemia is the most prevalent nutritional deficiency disorder and the leading cause of anemia in children, especially in developing countries.
Causes of Anemia in Children
The causes of anemia in children can be categorized into several groups, including:
- Increased demand for iron
- Inadequate iron intake
- Decreased iron absorption (malabsorption)
- Increased blood loss
- Defective plasma iron transport, as mentioned in 1
- Genetic hemoglobin disorders
- Blood loss
- Infections
- Other diseases, as discussed in 2
Clinical Manifestations of Anemia in Children
The clinical manifestations of anemia in children vary depending on the severity of the condition. According to 1, most children with mild iron deficiency anemia are asymptomatic, while those with more severe anemia may exhibit symptoms such as:
- Pallor
- Poor appetite
- Fatigability
- Lassitude
- Lethargy
- Exercise intolerance
- Irritability
- Dizziness
- Tachycardia
- Shortness of breath
- Diaphoresis
- Poor capillary refilling
Diagnosis of Anemia in Children
The diagnosis of anemia in children involves a combination of physical examination, medical history, and laboratory tests. According to 2, the initial laboratory evaluation consists of a complete blood cell count, with further testing dependent on mean corpuscular volume. A low serum ferritin level may confirm the diagnosis of iron deficiency anemia, as mentioned in 1.
Treatment of Anemia in Children
The treatment of anemia in children depends on the underlying cause. For iron deficiency anemia, oral iron therapy is the first-line treatment, with a recommended dosage of 3 to 6 mg/kg of elemental iron per day, as discussed in 1. According to 2, a recommended dosage of 2 to 6 mg/kg per day of ferrous sulfate is the most effective oral iron supplementation for patients with iron deficiency anemia.
Prevention of Anemia in Children
Prevention of anemia in children is crucial, especially in developing countries. According to 1, primary prevention can be achieved by supplementary iron or iron fortification of staple foods. The importance of dietary counseling and nutritional education cannot be overemphasized. Secondary prevention involves screening for, diagnosing, and treating iron deficiency anemia, as recommended by the American Academy of Pediatrics, as mentioned in 1 and 2.
Differential Diagnosis and Caveats
It is essential to consider the differential diagnosis of anemia in children, including:
- Microcytic anemia (iron deficiency, thalassemia, lead poisoning)
- Normocytic anemia (hemolysis, hemoglobinopathies, membrane defects, enzymopathies)
- Macrocytic anemia (folic acid and/or vitamin B12 deficiency, hypothyroidism, liver disease), as discussed in 3 A pediatric hematology referral may be beneficial for patients who do not respond to treatment, and referrals are critical for any bone marrow suppression that is diagnosed, as mentioned in 2.