Anemia in children, causes, pathophysiology

Anemia in children and it’s causes

1. APPROACH TO CHILD WITH ANEMIA

2. DEFINITION: When Hb is 2 SD below mean for particular age and sex Condition in which there is tissue hypoxia due to inadequate oxygen carrying capacity of blood Anemia is a sign

3. Physiological ADAPTATIONs: Decreased oxygen release from Hb Decreased blood flow to tissues Tissue hypoxia Blood volum e: increase in plasma, redistribution of blood flow Cardiac Output : increased due to increase in stroke volume Increased oxygen delivery to tissues due to increased flow of blood Diversion of blood flow from tissues with lesser oxygen requirements to greater ones

4. Iron metabolism: Sources: Meat (heme as major source), inorganic iron found in vegetables Healthy infants have a total body iron of 250 mg ( 80 ppm ) Decreases to 60 ppm Breast milk iron content is more bioavailable than cow’s milk

5. B12 metabolism: Sources: Animal products like meat, fish and eggs Also known as cobalamin B12 deficiency due to decreased ingestion impaired absorption eg. Due to intestinal parasites, failure to release from protein, intrinsic factor deficiency or impaired utilization eg. Congenital enzyme deficiencies like orotic aciduria Folate deficiency causes: decreased ingestion, impaired absorption eg. Celiac disease, impaired utilization eg. Methotrexate, 6-mercaptopurine, azathioprine, increased requirement eg. Infancy,hyperthyroidism , chronic hemolytic disease