TEXTBOOK & DISCUSSION

Definition:
Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your
body's tissues. Having anemia can make you feel tired and weak.

There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it
can range from mild to severe. See your doctor if you suspect that you have anemia. It can be a warning
sign of serious illness.

Treatments for anemia range from taking supplements to undergoing medical procedures. You might be
able to prevent some types of anemia by eating a healthy, varied diet.

Cause:
Anemia has 3 main causes:

 Loss of red blood cells from bleeding

 Inability to make enough red blood cells
 A medical condition that causes the destruction of red blood cells
Screening for anemia is an important part of caring for a child. Many problems caused by
anemia can be prevented when anemia in children is diagnosed at an early stage. In most cases,
anemia can be diagnosed with a few simple blood tests. The American Academy of Pediatrics
currently advises screening for anemia with a hemoglobin test at age 1. It should include
looking for risk factors for iron deficiency anemia. If the hemoglobin level is low, more testing is
needed to determine the type of anemia. If a child has any risk factors at any age, a test for
anemia should be done. For older children, a blood test for anemia may be done during a child's
routine exam.

 Aplastic anemia: Aplastic anemia is a condition that occurs when your body stops producing
enough new blood cells. Aplastic anemia leaves you feeling fatigued and with a higher risk of
infections and uncontrolled bleeding.
A rare and serious condition, aplastic anemia can develop at any age. Aplastic anemia may occur
suddenly, or it can occur slowly and get worse over a long period of time. Treatment for aplastic anemia
may include medications, blood transfusions or a stem cell transplant, also known as a bone marrow
transplant.

 Iron deficiency anemia: Iron deficiency anemia is a common type of anemia — a condition in
which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's
tissues.

As the name implies, iron deficiency anemia is due to insufficient iron. Without enough iron, your body
can't produce enough of a substance in red blood cells that enables them to carry oxygen (hemoglobin).
As a result, iron deficiency anemia may leave you tired and short of breath.

You can usually correct iron deficiency anemia with iron supplementation. Sometimes additional tests or
treatments for iron deficiency anemia are necessary, especially if your doctor suspects that you're
bleeding internally.

 Sickle cell anemia: Sickle cell anemia is an inherited form of anemia — a condition in which
there aren't enough healthy red blood cells to carry adequate oxygen throughout your body.

Normally, your red blood cells are flexible and round, moving easily through your blood vessels. In sickle
cell anemia, the red blood cells become rigid and sticky and are shaped like sickles or crescent moons.
These irregularly shaped cells can get stuck in small blood vessels, which can slow or block blood flow
and oxygen to parts of the body.

There's no cure for most people with sickle cell anemia. But treatments can relieve pain and help
prevent problems associated with the disease .

Thalassemia: Thalassemia is an inherited blood disorder characterized by less hemoglobin and fewer
red blood cells in your body than normal. Hemoglobin is the substance in your red blood cells that
allows them to carry oxygen. The low hemoglobin and fewer red blood cells of thalassemia may cause
anemia, leaving you fatigued.

If you have mild thalassemia, you may not need treatment. But if you have a more severe form of the
disorder, you may need regular blood transfusions. You can also take steps on your own to cope with
fatigue, such as choosing a healthy diet and exercising regularly.
Vitamin deficiency anemia: Vitamin deficiency anemia is a lack of healthy red blood cells caused when
you have lower than normal amounts of certain vitamins. Vitamins linked to vitamin deficiency anemia
include folate, vitamin B-12 and vitamin C.

Vitamin deficiency anemia can occur if you don't eat enough folate, vitamin B-12 or vitamin C. Or
vitamin deficiency anemia can occur if your body has trouble absorbing or processing these vitamins.

Not all anemias are caused by a vitamin deficiency. Other causes include iron deficiency and certain
blood diseases. That's why it's important to have your doctor diagnose and treat your anemia. Vitamin
deficiency anemia can usually be corrected with vitamin supplements and changes to your diet.

Clinical Manifestation:
Anemia signs and symptoms vary depending on the cause. If the anemia is caused by a
chronic disease, the disease can mask them, so that the anemia might be detected by
tests for another condition.

Depending on the causes of your anemia, you might have no symptoms. Although the
child may be asymptomatic, if they do occur, might include:

 Fatigue

 Weakness

 Pale or yellowish skin

 Irregular heartbeats

 Shortness of breath

 Dizziness or lightheadedness

 Chest pain

 Cold hands and feet

 Headaches
 Diagnostic procedures:
Blood tests may cause a little discomfort while the needle is inserted. The needle may cause
some bruising or swelling. After the needle is removed, the healthcare provider will remove the
tourniquet. He or she will put pressure on the area, and apply a bandage. 
It's possible to have persistent bleeding, nerve damage, or infections from a blood test. But
these risks are low. In most cases, a child will not need any special preparation or care after a
blood test.

Most types of anemia in children can be diagnosed with these blood tests:

 Hemoglobin and hematocrit. This is often the first screening test for anemia in children.
It measures the amount of hemoglobin in the blood and the amount of red blood cells in the
blood sample.
 Complete blood count (CBC). If hemoglobin or hematocrit is abnormal, a complete
blood count may be done. This test adds important information about the blood, including the
size of red blood cells (called the mean corpuscular volume, or MCV).
 Peripheral smear. This test is done with a smear of blood on a slide that is examined
under a microscope. By looking at a child's blood cells under a microscope, a lab specialist may
be able to diagnose a type of anemia that causes red cells to grow or develop abnormally.
 Reticulocyte count. Reticulocytes are immature blood cells. A reticulocyte count
measures the amount of newly formed red blood cells in the child's blood sample. Anemia
caused by not enough red blood cells being made results in a low reticulocyte count. Anemia
caused by too many red blood cells being lost causes a high reticulocyte count.

Treatment
Medical and surgical Procedures:
Anemia is a broad medical topic. Treatment depends on your specific diagnosis and the severity of your
condition. Your doctor will tailor these treatments to your diagnosis. Different diagnoses and their
treatments may include:

 Iron deficiency anemia – iron supplements, medications, blood transfusions, surgery, or even
cancer treatment
 Anemia related to chronic disease – treatment of the underlying disease, blood transfusions, or
synthetic hormone injections to boost red blood cell production
 Aplastic anemia – medications and blood transfusions to boost red blood cell levels
 Anemia related to autoimmune disorders – drugs to suppress the immune system
 Anemia related to bone marrow disease – medication, chemotherapy or bone marrow
transplant
 Hemolytic anemia – spleen removal, drugs to suppress the immune system, blood transfusions,
or blood filtering
 Sickle cell anemia – medications, oxygen, blood transfusions, folic acid supplements, antibiotics,
bone marrow transplant
 Thalassemia – blood transfusions, folic acid supplements, spleen removal, or bone marrow
transplant