Anemia in children. Diagnostics and prevention
Anemia is a condition in which the amount of red blood cells (red blood cells) in the blood becomes too low. It is in erythrocytes that hemoglobin is located – a protein that distributes oxygen throughout the body.
The norms of hemoglobin in children are different depending on age and differ from adults.
In children from 6 months to 5 years old, anemia is considered to be a decrease in the hemoglobin level below 110 g / l, from 5 to 11 years – below 115 g / l, at an older age, the hemoglobin norm approaches the norm of adults. At the age of up to 6 months, children sometimes experience the so-called physiological anemia of newborns, while the hemoglobin level can decrease to 90 g / l, and in the absence of other reasons, this condition does not require treatment.
Anemia can be critical for a growing and developing child’s body. When the level of red blood cells and hemoglobin is low, organs and tissues receive insufficient oxygen. If this condition continues for a long time, the child’s physical, psychomotor and mental development is impaired. That is why it is important not only to timely diagnose and treat anemia, but also to prevent it in risk groups.
Causes of anemia
There are many reasons for a decrease in the level of erythrocytes , the main ones can be divided into three groups:
- insufficient production of red blood cells;
- premature destruction of red blood cells (hemolysis);
- blood loss.
Insufficient production of red blood cells
For the formation of hemoglobin and red blood cells, the body requires trace elements such as iron, as well as vitamins B12 and folic acid. With a significant deficiency of these elements, the production of erythrocytes decreases and iron, B12 or folate deficiency anemia develops. At the same time, iron deficiency is the most common cause of anemia in children, especially under the age of 5 years.
Red blood cells are formed from progenitor stem cells found in the bone marrow. A decrease in the number of stem cells or impairment of their function can also lead to a decrease in the number of red blood cells and the occurrence of anemia. Such conditions can be congenital or acquired.
Premature destruction of red blood cells
Anemia resulting from hemolysis can be observed in children with congenital genetically determined pathologies of erythrocytes, for example, with thalassemia or spherocytosis. At an older age, hemolysis can be caused by autoimmune diseases, infections, taking certain medications, liver and kidney diseases, and a number of other diseases, such as microangiopathy. Shilajit
An increased loss of erythrocytes can be observed with overt or latent blood loss. In children and adolescents, among the obvious blood loss, nose and uterine bleeding (heavy menstruation) is most common. Latent blood loss can be observed with kidney disease, as well as inflammatory diseases of the gastrointestinal tract.
Diagnosis of anemia
Anemia in a child can be suspected in the presence of constant lethargy, tearfulness, irritability, sleep disturbance, poor exercise tolerance, memory loss and school performance.
On examination, there may be pallor (and with hemolysis – yellowness) of the skin, as well as an increased heart rate.
Depending on the cause of the anemia, additional symptoms may include brittle nails, increased hair loss, mouth sores, taste changes (the child may be attracted to inedible foods such as chalk, earth, ash), numbness in the limbs, muscle pain, enlarged liver and spleen …
If you suspect anemia, your doctor may:
- ask about what worries the child;
- inquire about the peculiarities of his nutrition;
- find out if family members have anemia;
- conduct a physical examination of the child.
To confirm the diagnosis, the doctor will prescribe the necessary tests:
- clinical blood test,
- blood test for reticulocytes;
- blood chemistry;
- general urine analysis, feces analysis;
- test for hereditary anemia;
- bone marrow stem cell research;
- Ultrasound, endoscopic examinations.
If there is a suspicion of a malfunction of bone marrow stem cells, such studies as myelogram, cytogenetic, molecular biological studies of the bone marrow are performed. To obtain material, a bone puncture is performed with a special needle. For children, this procedure is performed under general anesthesia.
Treatment of anemia in children
Treatment always depends on the cause and severity of the anemia. In addition to the obligatory visit to a hematologist, the child may need:
- diet correction;
- taking medications;
- in case of severe anemia, blood transfusion;
- for a number of anemias associated with disruption of stem cells, bone marrow transplantation.
For example, if your child has iron deficiency anemia, the doctor will prescribe iron supplements. After a while, the doctor will recommend a second blood test. If the hemoglobin level returns to normal and the child’s well-being improves, treatment should not be stopped. Your doctor will recommend that you continue taking iron supplements for several more months. This will replenish internal iron stores and prevent the recurrence of anemia.
To get enough iron from your diet, you need to follow a balanced diet. Good sources of iron are primarily animal products (meat, liver, seafood). Among the products of plant origin, you should pay attention to rose hips, green beans, nuts, mushrooms, apples, pomegranate, strawberries, spinach.
Since not only iron deficiency can lead to anemia, it is not worth starting therapy with iron preparations until the cause of the anemia is clarified. If anemia is found in the blood test of your child, contact the hematologist, he will prescribe the necessary tests and determine the therapy plan.