Anemia in children

What is anemia?

Anemia is a common blood disorder that occurs when there are fewer red blood cells than normal, or there is a low concentration of hemoglobin in the blood.

• Hemoglobin - the part of blood that distributes oxygen from the lungs to tissues in the body.
• Hematocrit - the measurement of the percentage of red blood cells found in a specific volume of blood.

Anemia is often a symptom of a disease rather than a disease itself. Anemia usually develops due to the presence of one of the following:

• Excessive blood loss or hemorrhaging.
• Deficient production of red blood cells.
• Excessive red blood cell destruction.
• Both decreased production and excessive destruction of red blood cells.

What are the symptoms of anemia in children?

Most symptoms of anemia are a result of the decrease of oxygen in the cells or "hypoxia." Because red blood cells, as hemoglobin, carry oxygen, a decreased production or number of these cells result in "hypoxia." Many of the symptoms will not be present with mild anemia, as the body can often compensate for gradual changes in hemoglobin.

The following are the most common symptoms for anemia. However, each child may experience symptoms differently. The symptoms may include, but are not limited to, the following:

• Abnormal paleness or lack of color of the skin.
• Increased heart rate (tachycardia).
• Breathlessness, or difficulty catching a breath (dyspnea).
• Lack of energy, or tiring easily (fatigue).
• Dizziness, or vertigo especially when standing.
• Headache.
• Irritability.
• Irregular menstruation cycles.
• Absent or delayed menstruation (amenorrhea).
• Sore or swollen tongue (glossitis).
• Jaundice, or yellowing of skin, eyes, and mouth.
• Enlarged spleen or liver (splenomegaly, hepatomegaly).
• Slow or delayed growth and development.
• Impaired wound and tissue healing.

The symptoms of anemia may resemble other blood disorders or medical problems. Because anemia is often a symptom associated with another disease, it is important for your child's physician to be aware of symptoms your child may be experiencing. Always consult your child's physician for a diagnosis.

How is anemia diagnosed?

Anemia may be suspected from general findings on a complete medical history and physical examination of your child, such as complaints of tiring easily, pale skin and lips, or a fast heartbeat (tachycardia). Anemia is usually discovered during a medical examination through blood tests that measure the concentration of hemoglobin and the number of red blood cells.

In addition to a complete medical history and physical examination, diagnostic procedures for anemia may include:

• Additional blood tests.
• Bone marrow aspiration and biopsy - marrow may be removed by aspiration or a needle biopsy under local anesthesia. In aspiration biopsy, a fluid specimen is removed from the bone marrow. In a needle biopsy, marrow cells (not fluid) are removed. These methods are often used together.

What causes anemia in children?

Generally, anemia may be caused by several problems, including the following:

• Infection.
• Certain diseases.
• Certain medications.
• Poor nutrition.

What are the different types of anemia?

• Iron deficiency anemia.
• Megaloblastic (pernicious) anemia.
• Hemolytic anemia.
• Sickle cell anemia.
• Cooley's anemia (thalassemia).
• Aplastic anemia. 
• Chronic anemia.

Treatments for anemia in children

Specific treatment for anemia will be determined by your child's physician based on the following:

• Your child's age, overall health and medical history.
• The extent of the anemia.
• The type of anemia.
• Cause of the anemia.
• Your child's tolerance for specific medications, procedures or therapies.
• Expectations for the course of the anemia.
• Your opinion or preference.

Anemia can be difficult to treat and may include:

• Vitamin and mineral supplements.
• Change in your child's diet.
• Medication and/or discontinuing causative medications.
• Treatment of the causative disorder.
• Surgery to remove spleen (if related to hemolytic anemia).
• Blood transfusions, if necessary (to replace significant loss).
• Antibiotics (if infection is causative agent).
• Bone marrow transplant (for aplastic anemia).