- USA : Outpatients, in patients, intensive care management Experience.
- INDIA : Experience in all branches of medicine, with exclusive work in Rural
Anemia in infancy and childhoodhas many causes. It is important to find the route cause and to initiate early and acute treatment, for very often anemia can be a typical presentation of a typical disease.
In anemic child who is iron deficient looks pale, tired, anorexic, with behavioral abnormalities (irritability confusion, with poor attention and learning span)These children also have tachy cardia, heart murmur,palpable spleen, under poor weight gain etc.
Iron deficiency which is typical in Indian setting go through stages of Iron depletion, iron deficient erythropoiesis, and then iron deficiency.
Complete and often extensive investigations are required for children which have multisystemic presentation with anemia. The following tabulations give a simple approach to a patient with anemia.
| Parameter | Upwards(false positive) | Downwards(false negative) |
|---|---|---|
| Leukocyte Count | Platelet Aggregation(antibodies) Normoblasts | Agglutination Of The Leukocytes |
| Erythocyte Count | High Leukocytosis Platet Ahhregation | Marked Microcytosis(+Fragmentation)Agglutination(Counted As Leukocytes) Hemolysis |
| Platelet Count | HemolysisLeukemiasMicrocytosisCryoglobulinemiaLipid Infusion | Platelet AggregationMacrothromocytosisPlatelet Adhesion |
| HB | In Vivo HemolysisHyperbillirubiemiaHyperlipidemia | |
| MCV | AgglutinationHyperglycemia(Osmolality) |
1) Severe anemia may require blood transfusion.
2) Moderate to low anemias require oral supplementation of iron and vitamins. The dose is calculated with regards the body weight of the child. (3 ml/kg per day of elemental iron).
3) Response to therapy begins with decreased irritability and improved appetite within 24 hrs. Followed by an increase in retic count within 3 days.Hemoglobin increased within 5 – 7 days.
4) Patient education, nutritional counseling, ruling out common cause such as pica and warm infestation is important.