anemia%20-%20iron-deficiency%20(pediatric)
ANEMIA - IRON-DEFICIENCY (PEDIATRIC)

Iron deficiency (ID) is the most common nutritional deficiency in children & reportedly 3x more common than iron-deficiency anemia, but does not always develop into anemia.

Neonates & children may have delayed growth & development; adolescents may show decrements of learning such as behavioral abnormalities.

Iron-deficiency anemia is the most advanced stage of iron deficiency resulted from a protracted imbalance between iron intake & demand.

Characterized by low hemoglobin & hematocrit levels, reduction or depletion of iron stores, low serum iron levels & decreased transferrin saturation.

Follow Up

  • There are no standard recommendations for follow up after starting iron therapy but patients who are in need of further medical attention may be referred to specialists
  • Referral is recommended if with disease progression or if with unresponsiveness to treatment
    • Obtain complete blood count (CBC) every 3 months for 1 year
    • Response to iron therapy is observed after weeks of treatment, should be asked to return for evaluation
    • Reassessment of treatment plan is advised if without favorable response
    • Consider referral to a hematologist for further investigation of the source of anemia
    • Consider referral to a gastroenterologist for treatment of underlying gastrointestinal lesions or suspected cancer and evaluation of gastrointestinal bleeding
  • Further follow-ups are not necessary if the patient is asymptomatic and the hematocrit level is normal
  • If hemoglobin and red blood cells (RBC) indices remain normal, one additional CBC should be obtained 12 months later
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