Description
Iron deficiency anemia in pediatrics is a common condition characterized by insufficient iron levels, leading to decreased hemoglobin production and reduced oxygen-carrying capacity of the blood. It typically presents with symptoms such as fatigue, pallor, irritability, and poor feeding. Risk factors include premature birth, low birth weight, inadequate dietary intake, and rapid growth periods. Diagnosis is confirmed through laboratory tests showing low hemoglobin, hematocrit, and serum ferritin levels. Management involves dietary modifications to increase iron-rich foods, and iron supplementation with close monitoring of hematologic response and potential side effects such as gastrointestinal discomfort. Early detection and treatment are crucial to prevent cognitive and developmental delays.
Résumé
- Iron deficiency anemia is a prevalent nutritional disorder globally, especially in developing countries, affecting a significant percentage of children. Surveys in India have shown high anemia rates, with a considerable proportion of children experiencing mild to severe forms. Anemia is defined by hemoglobin levels below specific thresholds based on age, with a concerning increase in prevalence in recent surveys in many Indian states.
- Iron plays a crucial role in the body, primarily in hemoglobin formation for oxygen transport. The liver serves as a major storage organ for iron, with a daily cycle of iron circulation facilitated by the reticuloendothelial system. Dietary iron absorption in the duodenum is vital to compensate for daily iron losses and maintain a positive iron balance.
- Iron requirements vary by age, with infants requiring adequate iron intake, especially after six months when breast milk alone is insufficient. Low iron stores at birth, premature birth, or perinatal blood loss can increase the risk of iron deficiency. Delayed cord clamping at birth is recommended to improve iron status and reduce the risk of early iron deficiency.
- The causes of iron deficiency anemia include inadequate dietary intake, excessive cow's milk consumption, blood loss (e.g., from nosebleeds or intestinal issues), and helminth infections. The progression of iron deficiency involves depletion of tissue iron stores, decreased serum ferritin and iron levels, and impaired hemoglobin synthesis.
- Clinical manifestations of iron deficiency anemia can range from asymptomatic to reduced exercise capacity, fatigue, pica (consumption of non-food items), and potential exacerbation of breath-holding spells and febrile seizures. Diagnosis involves a thorough history, clinical examination, and laboratory investigations, including complete blood count, serum iron studies, and peripheral blood smear analysis.
- Differential diagnosis includes alpha and beta thalassemia, hemoglobinopathies, anemia of inflammation, and lead poisoning. Treatment primarily involves oral iron supplementation at 3-6 mg/kg of elemental iron, continued for two to three months after blood values normalize. Dietary counseling to increase iron-rich foods and deworming medication (albendazole) are also recommended.
- In cases of poor response to oral iron, consider factors such as poor compliance, malabsorption, concurrent vitamin deficiencies, ongoing blood loss, inflammation, or misdiagnosis. Iron-rich foods include green leafy vegetables, poultry, red meat, fish, legumes, seeds, dark chocolate, nuts, and dried fruits. Blood transfusion is rarely required, typically reserved for cases of heart failure or severe blood loss.
Exemple de certificat
À propos des intervenants
Commentaires
Commentaires
Vous devez être connecté pour laisser un commentaire.