Childhood anaemia Flashcards
What diagnoses should be considered in children with anaemia with an MCV <70?
IDA
Thalassaemia
How might IDA present in a child?
Poor diet Poverty Stomatitis Bleeding Koilonychia
How might thalassaemia present in a child?
Short stature Muddy complexion Icteric sclera Distended abdomen Hepatosplenomegaly Bossed skill Prominent maxillae
What 3 mechanisms can cause anaemia in a child?
Destruction
Lack of production
Loss of blood
What diagnoses should be considered in children with anaemia with an MCV >100?
Low folate
Low B12
Haemolysis
What diagnoses should be considered in children with anaemia with an MCV 81-97?
Haemolysis
Marrow failure
What are the potential causes for low folate in a child?
Malabsorption
Phenytoin
What are the potential causes for low B12 in a child?
Breast milk from a vegetarian
Decreased intrinsic factor
Malabsorption
Poor feeding
What are the potential symptoms of low B12 in a child?
Late milestones
Odd movements
Microcephaly
Failure to thrive
What can cause marrow failure in a child to cause anaemia?
Transient
After infection
Thyroid, kidney or liver failure
Malignancy
What are some severe tropical anaemias that may be found in children?
malaria bacteraemia worms HIV sickle cell
If a child has anaemia with a raised CRP and ESR what may this indicate?
Chronic disease
On a blood film in a child with anaemia, what do hypochromic microcytic RBCs indicate?
IDA
On a blood film in a child with anaemia, what do target cells indicate?
liver disease
Thalassaemia
What percentage of infants worldwide are affected by IDA?
26%
What is the peak age for a child to develop IDA?
~18 months
In recurrent IDA what diagnoses should be suspected in a child?
Meckel’s diverticulum
Oesophagitis
How is IDA treated in children?
Ferrous fumarate syrup at 0.25ml/kg/12h
In a child with anaemia, when should a diagnosis of malaria or sickle cell disease be considered?
Evidence of increased RBC production
Decreased RBC survival
Intravascular haemolysis
Inborn error of metabolism, spherocytosis
What is hereditary spherocytosis?
Autosomal dminant abnormality of erythrocytes causing them to be spherical rather than biconcave in shape
What happens to a person with hereditary spherocytosis if they develop a parovirus B19 infection?
transient severe anaemia
How is hereditary spherocytosis investigated?
Flow cytometric analysis of eosin-5-malemide
What treatment may be considered for hereditary spherocytosis to increase RBC survival?
Splenectomy
What is a complication of hereditary spherocytosis?
Gallstones in the 1st decade of life
What is the management for a patient with sickle-cell disease?
Hydrate Give O2 Pain relief - warmth - hydration - ibuprofen - pt-controlled analgesia
