Pediatric Anemia

The word anemia means that there are not enough red blood cells in the body to perform all of the body's functions. The main purpose of red blood cells is to carry oxygen to all of the tissues in the body. These red blood cells use iron to help carry oxygen to the cells in the body. This is why it is commonly stated that a person has "low iron" when they actually have low red blood cells.

Anemia in children and young adults is the most common blood problem diagnosed in the United States with approximately 1 billion people having anemia from nutritional deficiencies. These nutritional deficiencies can be from iron, vitamin B12 and folic acid.

Symptoms of Anemia

Patients with anemia can have symptoms that may vary depending on the age of the patient.

Symptoms include:

• Low energy
• More sleeping
• Decreased appetite
• Pale skin or nail beds
• Headaches
• Short of breath
• Chest pain

Causes of Anemia

Anemia has several different causes which can be from the red blood cell being destroyed in the body after they are released from the bone marrow (increased destruction) or the bone marrow is not making enough red blood cells (lack of production) or there is acute blood loss or chronic blood loss over a long period of time. The hemoglobin, mean corpuscle volume (MCV), which looks at the size of the red blood cell, and reticulocyte count help to figure out the cause of the anemia.

Some causes of anemia are listed below in the following categories:

• Increased Destruction
  • Autoimmune hemolytic anemia
  • Hemolytic anemia
  • Sickle cell disease
  • Spherocytosis Glucose-6-Phosphate
  • Dehydrogenase deficiency
• Infection mediated
  • Parvovirus
  • Epstein-Barr virus
  • Cytomegalovirus
  • HIV
  • Hepatitis
• Ineffective bone marrow production (defective hemoglobin)
  • Sickle cell disease
  • Alpha thalassemia
• Lack of Production
  • Bone marrow failure
  • Aplastic Anemia
  • Diamond-Blackfan Anemia
  • Transient Erythroblastopenia of Childhood
• Cancer in the Blood or Bone marrow
  • Leukemia cells take up space in the bone marrow and do not allow the bone marrow to make red blood cells. This will also affect white blood cell and platelet production
• Nutritional deficiencies
  • Iron – found in meat, beans, spinach, fortified cereal
  • Folic Acid – found in fruits and vegetables
  • Vitamin B12 – found in meat products, dairy products, cheese and eggs
• Acute Blood Loss (blood loss quickly)
  • Blood loss through the gastrointestinal tract
  • Blood loss through menstrual bleeding
  • Blood loss through blood in the urine
  • Any evidence of bleeding or increased bruising should be evaluated for a bleeding disorder with a Pediatric Hematologist
• Chronic Blood Loss (blood loss over a long period of time)
  • Associated with autoimmune diseases such as lupus, juvenile inflammatory arthritis

Diagnosing Anemia

The symptoms of anemia can be very vague and difficult to figure out so most doctors will order testing which screens for anemia.

Testing includes:

• A complete blood count (CBC)
• A reticulocyte count (early red blood cells that increase in the bone marrow in response to anemia)

The blood count measures the hemoglobin which is the substance in red blood cells that binds to oxygen. Hemoglobin uses iron to bind to the oxygen and transport the oxygen to your organs where the oxygen is released and keeps our organs healthy. The CBC also looks at the size of the red blood cell which helps the doctor determine what may be causing the anemia.

Managing Anemia

It is very important to eat a diet that is well balanced and not avoid certain food groups. For instance, iron rich foods include meats, beans, spinach, fortified cereals and breads. Vitamin B12 is also found in meat and dairy products as well as eggs. Folic acid is in several fruits and vegetables like broccoli, spinach, and oranges.

If you or someone you know is concerned that their child has anemia, please feel free to contact our office at 410-328-2808. We are more than happy to help figure out if your child has anemia.