Anemia in a child: signs, causes, diagnosis, treatment, clinical recommendations

The term "anemia" refers to a pathological condition in which the hemoglobin concentration decreases in a unit volume of liquid connective tissue. As a rule, the number of red blood cells also deviates from the norm in a smaller direction. As a result, body cells cannot fully satisfy their oxygen demand. Signs of anemia can appear not only in adults, but also in children. Moreover, in the latter case, it is necessary to consult a doctor as soon as possible. Ignoring signs of anemia in a child can lead to irreversible consequences. Another name for the pathology is anemia.

Pathogenesis

Liquid connective tissue is represented by plasma and shaped elements. The latter include red blood cells, platelets and white blood cells. These cells differ from each other not only in shape and size, but also in functions.

Leukocytes in the blood least. Moreover, they perform an important protective function. Platelets are the thinnest plates that regulate the coagulation process of fluid connective tissue. They are responsible for stopping bleeding.

Red blood cells are red bodies with a biconvex shape. They are in the blood most. The cavity of each red blood cell is filled with an iron-containing protein - hemoglobin. It is he who is responsible for the delivery of oxygen to the tissues of the body. If there is very little hemoglobin in the blood, anemia develops. At this time, the body begins to suffer from oxygen starvation.

Etiology

There are several types of anemia. Moreover, the basis of the development mechanism of each of them is one of the following processes:

• Severe loss of fluid connective tissue.
• Violation of blood formation.
• Acceleration of the decay of red blood cells.

Types of anemia in children associated with impaired blood formation:

• Iron deficiency. A failure in the process of hemoglobin formation occurs due to a lack of a vital trace element in blood serum. Causes of iron deficiency anemia in children: unbalanced nutrition, accelerated growth of the body. In addition, the concentration of trace elements may decrease due to blood loss. The ICD-10 code for iron deficiency anemia is D50.
• Folic deficiency. It develops against the background of a lack of vitamin B9 in the body. The main reasons: unbalanced nutrition, malabsorption of the substance in the small intestine. This form of anemia may appear in the infant. This is due to the fact that newborns more than adults need folic acid. The code for ICD-10 is D52.9.
• Iron saturated. This pathological condition is characterized by an insufficient trace element content in red blood cells due to a violation of the heme synthesis process (the complex from which the hemoglobin molecule is formed). The main reasons: hereditary predisposition, regular contact of the body with lead or nickel. The code for ICD-10 is D53.
• B12-deficient. Causes of development: unbalanced nutrition, helminthic infestations, the presence of pathologies of a congenital nature. This form of anemia can develop in both an infant and an older baby. As a rule, the main reason is helminths. The code for ICD-10 is D51.
• Dyserythropoietic. The process of red blood cell formation is disturbed due to intoxication and the presence of congenital pathologies inherited by an autosomal recessive type. The code for ICD-10 is D64.4.
• Hypoplastic. The formation of red blood cells is disturbed against the background of inhibition of hematopoiesis in the bone marrow. The causes are hereditary and autoimmune diseases. In addition, signs of anemia in a child may appear after taking certain medications, in particular antibiotics. The code for ICD-10 is D61.9.

Post hemorrhagic anemia is associated with blood loss. The amount of hemoglobin decreases due to a decrease in the volume of circulating fluid connective tissue. The main causes of anemia in children: injuries, hemorrhagic diseases. The code for ICD-10 is D62.

Against the background of the destruction of red blood cells, hemolytic anemia develops. The main reasons: viral pathologies, hereditary diseases, the intake of certain groups of drugs. Codes according to ICD-10 - D55-D59.

In addition, the following diseases and conditions are provoking factors in the development of anemia in young children:

• Hemolytic disease.
• Primary bone marrow failure.
• Frequent episodes of nosebleeds.
• Hemophilia.
• Surgery.
• Hypotrophy.
• Lactase deficiency.
• Cystic fibrosis.
• Gluten intolerance.
• Rickets.
• Diathesis.
• Neurodermatitis.
• Endocarditis.
• Pyelonephritis.
• Systemic lupus erythematosus.

Signs of anemia in a child may appear shortly after birth if, during pregnancy, a woman suffered from severe toxicosis, fetoplacental insufficiency, and chronic hepatitis.

Clinical manifestations

As mentioned above, there are several types of ailment. However, they have many common symptoms.

Signs of anemia in a child:

• Dryness and pallor of the skin.
• Dullness and fragility of hair and nails.
• Formation of sores in the corners of the mouth. They do not heal for a long time.
• Cracks in the feet and hands.
• Frequent episodes of colds.
• Lethargy.
• Tearfulness.
• Drowsiness.
• Irritability.
• Sleep disturbance.
• The rapid onset of fatigue.
• Nausea, sometimes turning into vomiting.
• Diarrhea or, on the contrary, constipation.
• Impaired appetite.
• Dyspnea.
• Tachycardia.
• Dizziness.

According to statistical data, iron deficiency anemia is most often diagnosed in children (ICD-10 code above). If it is present, the following symptoms may be added to the above symptoms:

• The sclera of the eyes becomes blue.
• Excessive sweating.
• Unhealthy craving for non-food elements. Most often, children eat paper or earth.
• Caries.

According to an official document (clinical guidelines), anemia in children has a favorable prognosis only with timely medical attention. This pathological condition can be corrected, but ignoring it often leads to irreversible consequences.

Severity

It is customary to judge the stage of the course of the disease by the presence of red blood cells and hemoglobin in the biological material.

The degree of anemia in children:

• First one. This is the initial stage of development of the disease. With mild anemia in a child, hemoglobin in a concentration of 90 to 110 g / l is detected in the blood. The number of red blood cells is 3-10 ^{12 /} l.
• The second one. This is moderate anemia. For this stage, the characteristic number of red blood cells is 2.5-10 ¹² l, hemoglobin is from 70 to 90 g / l.
• The third. It is customary to talk about it in the case when the indicators fall below the above.

Moreover, the more pronounced anemia, the brighter the symptoms of the disease are manifested in the child.

Diagnostics

If you experience the first warning signs, you should contact your pediatrician. The doctor will examine the child and prescribe basic tests, based on the results of which he will draw up an effective treatment regimen or refer for consultation with narrow specialists.

Diagnosis of anemia in children involves a general and biochemical study of fluid connective tissue.

The following signs indicate an iron deficiency form:

• Reduced red blood cell count.
• Decrease in hemoglobin concentration.
• Hypochromia (red blood cells are weakly stained).
• Anisocytosis. Red blood cells are of different sizes.
• Poikilocytosis. Red blood cells have a different shape.
• Decreased serum iron.
• Decrease in transferrin coefficient.

Normal hemoglobin values ​​in children are shown in the table.

If hemolytic anemia is suspected, an additional benzidine test is indicated. During a blood test, fragments of red blood cells and normoblasts are detected. In addition, increased neutrophil count.

With B12-deficient anemia, the level of bilirubin and reticulocytes in the blood rises. In order to diagnose this form of the disease in severe cases, an additional puncture of the red bone marrow can be prescribed. If the gastrointestinal tract and liver are damaged, the doctor sends for ultrasound, FGDS, irrigoscopy and colonoscopy. It is important to know that unless absolutely necessary, such studies are not prescribed for children.

Treatment

According to clinical guidelines, anemia in children requires an integrated approach. The choice of treatment tactics directly depends on what form of the disease is diagnosed in the child.

The classic drug regimen for iron deficiency anemia includes the following drugs:

• Ferrum Lek.
• Maltofer.

If iron is practically not absorbed in the child’s body, these drugs are administered intravenously.

The duration of administration of drugs should not be less than 3 months. After normalizing the hemoglobin concentration, the drug treatment of anemia in children should be continued for several more weeks. This is due to the need to replenish micronutrient reserves in the body.

Treatment of anemia in children is usually carried out on an outpatient basis. If the disease is severe, hospitalization is indicated in the hospital.

Nursing care plan for iron deficiency anemia in children:

• Conducting a conversation with parents regarding the causes of the ailment, the need for its treatment and prevention.
• Making adjustments to the diet of the child or his mother (if the baby is breastfed and eats only milk).
• Providing complete and understandable information regarding the administration of medications.
• Making adjustments to the daily routine.
• Active patronage to monitor compliance with recommendations.

Treatment of hemolytic anemia involves the intravenous administration of diuretics and glucose solution. With a sharp decrease in the amount of hemoglobin, transfusion of donor erythrocyte mass is indicated.

If a hemolytic crisis occurs, in some cases, the only right solution is to remove the spleen. In most cases, after a splenectomy, the child completely recovers.

If the cause of the pathology is an autoimmune disease, glucocorticoid therapy is indicated. Most often, doctors prescribe Dexamethasone and Prednisolone.

With B12-deficient anemia, vitamin therapy is indicated. As a rule, doctors prescribe the drug “Cyanocobalamin”. The tool helps to saturate the body with vitamin B12.

Power Features

With iron deficiency anemia, it is important to adjust the diet. If you leave it the same, even taking medication will not lead to recovery.

If anemia is diagnosed in a child whose age has not yet reached 12 months, the diet should be followed by a nursing mother. An alternative to breast milk can be an artificial mixture with a high content of iron. A pediatrician should prescribe such a baby food. In addition, it is important to introduce complementary foods in a timely manner. At 8 months, the baby should first try meat. It is an excellent source of iron.

The principles of a therapeutic diet for children over 12 months and nursing mothers:

• You need to eat 4 to 6 times a day. Moreover, the size of one serving should not exceed 200 g.
• Dishes should be consumed exclusively in the form of heat. Very hot or too cold food negatively affects the intestinal mucosa, which impedes the absorption of iron.
• Products can be baked, stewed, boiled, steamed. Only fried foods are prohibited. This is due to the fact that during such processing, the process of formation of harmful compounds is launched in food, which negatively affects not only the gastrointestinal tract, but also the whole organism.
• Nursing mothers are strictly forbidden to drink alcohol-containing drinks. Alcohol is the main enemy of hemoglobin.
• About 2 liters of pure still water should be consumed per day. If you do not drink the liquid, the blood will begin to thicken, which will only worsen the course of the pathological process.

The list of permitted products for iron deficiency anemia is very long. In this regard, the child can eat almost everything as before, if there are no particular contraindications. Parents are advised to include the following products in their baby’s diet:

• Bran bread.
• Meat and fish of low-fat varieties. An excellent source of iron is beef liver.
• Fresh vegetables salads. You need to refuel them with olive oil.
• Porridge (buckwheat, barley, oatmeal).
• Milk and dairy products with a small percentage of fat content.
• Greens.
• Eggs in any form, but it is preferable to offer children a steam omelet.
• Honey.
• Berries and fruits (children under 3 years old do not want to offer watermelon).
• Of the drinks, it is recommended to give preference to pure still water, dried fruit compote and a rosehip decoction.

With B12-deficient anemia, it is necessary to make up for the lack of vitamin in the body. It is recommended to include the following products in the menu:

• Liver (beef, chicken and pork).
• Rabbit meat.
• The pork.
• Cod.
• Chicken eggs.
• Beetroot.
• Carrot.
• Tomatoes
• Oatmeal porridge.
• Apricots
• Bread.
• Honey.
• Zucchini.
• Squash.

With this form of anemia, it is recommended to exclude milk and butter baking from the diet.

It is important to remember that products must be offered to a child strictly in accordance with his age needs. If there are signs of an undesirable reaction, this or that food should be excluded from the diet, even if it is an excellent source of vitamin B12.

Forecast

With the timely detection of the disease, its outcome, as a rule, is favorable. At the initial stage of development, anemia is easily amenable to medical treatment. In some cases, it is possible to completely get rid of it, only by adjusting the diet and diet of the child.

In severe cases, the doctor decides on the advisability of splenectomy.

Ignoring the pathology can lead to irreversible consequences. The development of complications is due to the state of hypoxia. Parents should not delay the treatment, remembering that against the background of an ailment, the cells of the body do not receive the necessary amount of oxygen.

What is dangerous anemia in children:

• Disruption of the cardiovascular system.
• Nervous Disorders.
• Impaired kidney function.
• Frequent episodes of colds and infectious diseases. This is due to the fact that with anemia there is a significant weakening of the body's defenses.
• Backlog from peers in physical development.
• Impaired lymphatic system.
• Muscle weakness.
• Diseases of the musculoskeletal system.

If anemia is not treated, sooner or later there will be a disruption in the functioning of all organs and systems.

Prevention

Measures to prevent the development of anemia must be carried out at the stage of pregnancy. During gestation, a woman should monitor the hemoglobin index. With its reduced level, it is necessary to make adjustments to the diet. If necessary, the attending physician prescribes iron-containing drugs.

Prevention of anemia in young children:

• The baby should receive breast milk or an adapted mixture up to six months. You need to feed the baby as many times as he asks for it.
• You can not offer a child up to 6 months of goat and cow milk. It is undesirable to give him water. Pure non-carbonated liquid can only be offered to child artisans.
• From the moment a child reaches the age of 6 months, it is necessary to introduce complementary foods. The latter should contain all the necessary vitamins, micro and macro elements.
• The diet of children of preschool and school age should be balanced.

Compliance with these recommendations significantly reduces the likelihood of developing anemia.

Finally

Currently, children are increasingly being diagnosed with a condition characterized by a decrease in the concentration of hemoglobin in the blood. Against the background of anemia, the cells of the body do not receive the right amount of oxygen, hypoxia develops. The consequences of the disease are often irreversible. In this regard, when the first signs of anemia occur, it is necessary to show the child to the pediatrician.