Anaemia in Children Flashcards
What is the cut off value for anameia in children?
Haemoglobin less than 110g/L
What’s important to ask about in the history of a child with anaemia?
Take a good history focusing on travel, diet and ethnic origin and examine the child.
What are the causes of microcytic anaemia in children?
Microcytic – Iron deficiency usually as a result of poor diet, poverty, bleeding, stomatitis or koilonychia or thalassaemia which is more common in Mediterranean/SE Asian populations.
What are the causes of macrocytic anaemia in children?
Macrocytic – folate deficiency due to malabsorption or phenytoin, B12 deficiency due to breast milk from a vegetarian, reduced intrinsic factor or malabsorption or haemolysis
What are the causes of normocytic anaemia in children?
Normocytic – haemolysis or bone marrow suppression (can be transient after infections, thyroid, liver or kidney failure or malignancy.
How can you prevent anaemia in children?
Avoid cow’s milk when under 1, if formula fed give iron-fortified and wean at 4-6months, adequate vitamin C intake and iron supplements if premature.
How does iron deficient anaemia present in children?
Babies will be less happy, have reduced psychomotor development and poor cognition. Most commonly it occurs as a result of poor diet or Coeliac disease. If recurrent suspect chronic bleeding from meckel’s diverticulum or oesophagitis.
How should iron deficient anaemia be managed in children?
Treat with ferrous fumarate syrup
If poorly compliant give iron spangles sprinkled in yoghurt or ice cream
Safeguard for overdose issues
How should you assess for haemolysis?
Think could this be malaria or sickle cell disease. Get senior help and provide answers to these 4 questions:
Is there evidence of increased RBC production e.g. from reticulocytes?
Is there decreased RBC survival – bilirubin and jaundice?
Is there any intravascular haemolysis – haemoglobinuria?
Is there an inborn error of metabolism or spherocytosis etc.
