Definitions
Anaemia due to insufficient dietary intake or absorption of iron, and hemoglobin, which contains iron, cannot be formed. (microcytic anaemia)
Pathophysiology
iron is stored for later use in the bone marrow, liver, and spleen
Iron deficiency ranges from iron depletion, which yields little physiological damage, to iron deficiency anemia, which can affect the function of numerousorgan systems. Iron depletion causes the amount of stored iron to be reduced, but has no effect on the functional iron.
a person with no stored iron has no reserves to use if the body requires more iron.
Aetiology
Commonest: poor iron intake
Premature infants- risk due to low iron endowment at birth
Cow’s milk intolerance
Chronic blood loss (excessive menses)
Malabsoption (IBD)
Epidemiology
most common cause if haematologic disease in children
commonest between 9-24 months
Presentation
Pallor
Fatigue, malaise, weakness
Palpitations
Pagophobia (compulsive ice craving) or PICA
clinical stigmata of poor nutrition- obesity, underweight
neurologic or intellectual dysfunction
Severe deficiency- iritability, tachycardia, murmurs, cheilosis, dysphagia, koilonychia
Investigation
Iron studies:
- low seum iron
- low serum ferritin
- increased Total Iron Binding Capacity (TIBC)
Low MCV, low MCH, low Hb, elevated red cell distribution (RDW)
Low reticulocytes count
Stool for occult blood - GI bleed
Management
Treat underlying cause
Iron supplementation:
- 3mg/kg/d for mild
- 6mgkg/d for moderate/severe
- recheck hb & reticulocyte count in 1 week
Monitor for reticulocytosis & elevated iron after 1 month
Increase intake of iron-rich food- liver ,beef
Continue therapeutic iron supplementation for 2 months or more
Parental iron, Blood transfusion is rarely indicated
Breastfeed for at least the first 6 months of life
Iron-fortified formula and infant cereal
limit cow’s milk to 18-24oz/d after 1 year of age
Anaemia due to insufficient dietary intake or absorption of iron, and hemoglobin, which contains iron, cannot be formed. (microcytic anaemia)
Pathophysiology
iron is stored for later use in the bone marrow, liver, and spleen
Iron deficiency ranges from iron depletion, which yields little physiological damage, to iron deficiency anemia, which can affect the function of numerousorgan systems. Iron depletion causes the amount of stored iron to be reduced, but has no effect on the functional iron.
a person with no stored iron has no reserves to use if the body requires more iron.
Aetiology
Commonest: poor iron intake
Premature infants- risk due to low iron endowment at birth
Cow’s milk intolerance
Chronic blood loss (excessive menses)
Malabsoption (IBD)
Epidemiology
most common cause if haematologic disease in children
commonest between 9-24 months
Presentation
Pallor
Fatigue, malaise, weakness
Palpitations
Pagophobia (compulsive ice craving) or PICA
clinical stigmata of poor nutrition- obesity, underweight
neurologic or intellectual dysfunction
Severe deficiency- iritability, tachycardia, murmurs, cheilosis, dysphagia, koilonychia
Investigation
Iron studies:
- low seum iron
- low serum ferritin
- increased Total Iron Binding Capacity (TIBC)
Low MCV, low MCH, low Hb, elevated red cell distribution (RDW)
Low reticulocytes count
Stool for occult blood - GI bleed
Management
Treat underlying cause
Iron supplementation:
- 3mg/kg/d for mild
- 6mgkg/d for moderate/severe
- recheck hb & reticulocyte count in 1 week
Monitor for reticulocytosis & elevated iron after 1 month
Increase intake of iron-rich food- liver ,beef
Continue therapeutic iron supplementation for 2 months or more
Parental iron, Blood transfusion is rarely indicated
Breastfeed for at least the first 6 months of life
Iron-fortified formula and infant cereal
limit cow’s milk to 18-24oz/d after 1 year of age
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