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Evaluation of anemia in children.

Abstract

Anemia is defined as a hemoglobin level of less than the 5th percentile for age. Causes vary by age. Most children with anemia are asymptomatic, and the condition is detected on screening laboratory evaluation. Screening is recommended only for high-risk children. Anemia is classified as microcytic, normocytic, or macrocytic, based on the mean corpuscular volume. Mild microcytic anemia may be treated presumptively with oral iron therapy in children six to 36 months of age who have risk factors for iron deficiency anemia. If the anemia is severe or is unresponsive to iron therapy, the patient should be evaluated for gastrointestinal blood loss. Other tests used in the evaluation of microcytic anemia include serum iron studies, lead levels, and hemoglobin electrophoresis. Normocytic anemia may be caused by chronic disease, hemolysis, or bone marrow disorders. Workup of normocytic anemia is based on bone marrow function as determined by the reticulocyte count. If the reticulocyte count is elevated, the patient should be evaluated for blood loss or hemolysis. A low reticulocyte count suggests aplasia or a bone marrow disorder. Common tests used in the evaluation of macrocytic anemias include vitamin B12 and folate levels, and thyroid function testing. A peripheral smear can provide additional information in patients with anemia of any morphology.

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  • Authors+Show Affiliations

    ,

    Johns Hopkins Community Physicians, Hagerstown, MD, USA. jcox21@jhmi.edu

    Source

    American family physician 81:12 2010 Jun 15 pg 1462-71

    MeSH

    Adolescent
    Age Factors
    Anemia
    Anemia, Iron-Deficiency
    Anemia, Macrocytic
    Blood Transfusion
    Child
    Child, Preschool
    Erythrocyte Count
    Erythrocyte Indices
    Hemoglobins
    Humans
    Infant
    Infant, Newborn
    Iron
    Reticulocyte Count
    Risk Factors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    20540485

    Citation

    Janus, Jennifer, and Sarah K. Moerschel. "Evaluation of Anemia in Children." American Family Physician, vol. 81, no. 12, 2010, pp. 1462-71.
    Janus J, Moerschel SK. Evaluation of anemia in children. Am Fam Physician. 2010;81(12):1462-71.
    Janus, J., & Moerschel, S. K. (2010). Evaluation of anemia in children. American Family Physician, 81(12), pp. 1462-71.
    Janus J, Moerschel SK. Evaluation of Anemia in Children. Am Fam Physician. 2010 Jun 15;81(12):1462-71. PubMed PMID: 20540485.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Evaluation of anemia in children. AU - Janus,Jennifer, AU - Moerschel,Sarah K, PY - 2010/6/15/entrez PY - 2010/6/15/pubmed PY - 2010/6/29/medline SP - 1462 EP - 71 JF - American family physician JO - Am Fam Physician VL - 81 IS - 12 N2 - Anemia is defined as a hemoglobin level of less than the 5th percentile for age. Causes vary by age. Most children with anemia are asymptomatic, and the condition is detected on screening laboratory evaluation. Screening is recommended only for high-risk children. Anemia is classified as microcytic, normocytic, or macrocytic, based on the mean corpuscular volume. Mild microcytic anemia may be treated presumptively with oral iron therapy in children six to 36 months of age who have risk factors for iron deficiency anemia. If the anemia is severe or is unresponsive to iron therapy, the patient should be evaluated for gastrointestinal blood loss. Other tests used in the evaluation of microcytic anemia include serum iron studies, lead levels, and hemoglobin electrophoresis. Normocytic anemia may be caused by chronic disease, hemolysis, or bone marrow disorders. Workup of normocytic anemia is based on bone marrow function as determined by the reticulocyte count. If the reticulocyte count is elevated, the patient should be evaluated for blood loss or hemolysis. A low reticulocyte count suggests aplasia or a bone marrow disorder. Common tests used in the evaluation of macrocytic anemias include vitamin B12 and folate levels, and thyroid function testing. A peripheral smear can provide additional information in patients with anemia of any morphology. SN - 1532-0650 UR - https://www.unboundmedicine.com/medline/citation/20540485/Evaluation_of_anemia_in_children_ L2 - http://www.aafp.org/link_out?pmid=20540485 DB - PRIME DP - Unbound Medicine ER -