Iron Deficiency Anemia

Question 1

The MC hematologic disease of infancy and childhood

Answer 1

Iron Deficiency Anemia

9-24 mos

poor dietary intake - MCC

Question 2

Etiology in Infants and Toddlers

Answer 2

low birth weight infants
prematurity
perinatal blood loss
early cord clamping
excessive consumption of cow’s milk

Question 3

Etiology in Older Children and Adolescents

Answer 3

↑ requirements (i.e. growth spurt, pregnancy)

occult/chronic blood loss (i.e. peptic ulcer, polyp, hemangiomas)

menstrual blood loss

infection w/ intestinal hookworm, Trichuris, Plasmodium, Helicobacter pylori, Giardia lamblia

Question 4

Hgb 6-10 g/dL

Answer 4

mild irritability

Question 5

Hgb 7-8 g/dL

Answer 5

pallor - MOST IMPORTANT CLINICAL SIGN

Question 6

Hgb <5 g/dL

Answer 6

lethargy, anorexia, easy fatigability, systolic flow murmurs and high output cardiac failure

Question 7

NONHEMATOLOGIC SYSTEMIC EFFECTS

Answer 7

koilonychia – spoon nails
pica - desire to ingest nonnutritive substances
pagophagia – desire to ingest ice
plumbism - ingestion of lead containing substances

Question 8

CBC IDA

Answer 8

low RBC
low MCV
low reticulocyte count
increased RDW (Thalassemia - normal RDW)
normal WBC count
normal or elevated  platelet count

Question 9

PBS IDA

Answer 9

microcytic, hypochromic RBCs

Question 10

Other Tests IDA

Answer 10

↓ serum iron
↓ serum ferritin (storage form of iron)
↑ the iron-binding capacity of the serum (serum transferrin)
↑ free erythrocyte protoporphyrins

Question 11

Expected Response to Iron Therapy

Answer 11

12-24 hrs - subjective improvement (↑ appetite, ↓ irritability)
36-48 hrs - initial bone marrow response (erythroid hyperplasia)
48-72 hrs - reticulocytosis - peaks 5-7 days
4-30 days - ↑ hgb levels
1-3 mos - repletion of iron stores

Question 12

3 mo
pica and pallor
irritable with poor appetite
milk diet (purely)

Answer 12

IDA