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Slovenska pediatrija 2012; 19: 35-43

https://doi.org/

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Review article

EVALUATION OF A CHILD WITH ANAEMIA

V. Rajić
Klinični oddelek za otroško hematologijo in onkologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

J. Jazbec
Klinični oddelek za hematologijo in onkologijo, Pediatrična klinika Ljubljana, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Abstract

Anaemia can be defined as a reduction in haemoglobin concentration two standard deviations below the mean for age and sex for the normal population, in the haematocrit or in the number of red blood cells per cubic millimetre. When a patient presents with anaemia, it is important to establish whether the abnormality is isolated to the red blood cells only or whether it is part of a pancytopenia. Anaemia can be classified in several ways, but the most commonly used pathophysiological classification takes into account the mechanisms of the origin of the anaemia. Thus it can be classified as follows: disturbances in erythropoiesis or insufficient erythropoiesis, depending on the degree of anaemia, disturbances in the maturation of red cells and ineffective erythropoiesis, bleeding and haemolytic anaemias. On the basis of the mean corpuscular volume (MCV) anaemia can be divided into microcytic, normocytic and macrocytic. The MCV and reticulocyte count are helpful in the differential diagnosis of anaemia, with an elevated reticulocyte count suggesting chronic blood loss or haemolysis and a low count suggesting impaired red cell formation. The most common anaemia in childhood is iron deficiency anaemia (microcytic). It is especially common in the periods of intensive growth (in infants, teenagers and adolescents). Oral iron supplementation is very successful, with a good response to treatment being indicated by a reticulocytosis.

Key words: anaemia, child, microcytic, iron deficiency.