Iron Deficiency Anemia

Published on 21/03/2015 by admin

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Last modified 21/03/2015

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Chapter 45 Iron Deficiency Anemia

PATHOPHYSIOLOGY

Iron deficiency anemia is the most common anemia affecting children in North America. The full-term infant born of a well-nourished, nonanemic mother has sufficient iron stores until the birth weight is doubled, generally at 4 to 6 months. Iron deficiency anemia is generally not evident until 9 months of age. After that, iron must be available from the diet to meet the child’s nutritional needs. If dietary iron intake is insufficient, iron deficiency anemia results. Most often, insufficient dietary iron intake results from inappropriately early introduction of solid foods (before age 4 to 6 months), discontinuation of iron-fortified infant formula or breast milk before age 1 year, and excessive consumption of cow’s milk to the exclusion of iron-rich solids in the toddler. Also, the preterm infant, the infant with significant perinatal blood loss, and the infant born to a poorly nourished, iron-deficient mother may have inadequate iron stores. Such an infant would be at a significantly higher risk for iron deficiency anemia before age 6 months. Maternal iron deficiency may cause low birth weight and preterm delivery.

Iron deficiency anemia may also result from chronic blood loss. In the infant, this may be due to chronic intestinal bleeding caused by the heat-labile protein in cow’s milk. In children of all ages, the loss of as little as 1 to 7 ml of blood daily through the gastrointestinal tract may lead to iron deficiency anemia. Other causes of iron deficiency anemia include nutritional deficiencies such as folate (vitamin B12) deficiency, sickle cell anemia, thalassemia major, infections, and chronic inflammation. In teenaged girls, iron deficiency anemia may also be due to excessive menstrual flow.

LABORATORY AND DIAGNOSTIC TESTS

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