Anemia

What is anemia?

Anemia is a common blood disorder that occurs when there are fewer red blood cells than normal, and there is not enough hemoglobin transported to supply the body:

• Hemoglobin. This is the part of red blood cells that distribute oxygen from the lungs to tissues in the body and carries carbon dioxide back to the lungs to be removed from 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

• Sequestration (the pooling of red cells in the spleen, an organ in your abdomen that helps fight infections)

What are the symptoms of anemia?

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:

• 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 doctor to be aware of symptoms he or she may be experiencing. Always consult your child's doctor for a diagnosis.

What causes anemia?

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

How is anemia diagnosed?

Anemia may be suspected on a complete medical history and physical examination of your child, such as complaints of tiring easily, pale skin and lips, shortness of breath, 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/or biopsy. A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.

Treatments for anemia

Specific treatment for anemia will be determined by your child's doctor 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)