The Characteristics of Severe Iron Deficiency Anemia in Children and Adolescents

Kwon, Hye Won; Kwon, Sung Eun; Lee, Ji Eun; Jun, Yong Hoon; Kim, Soon Ki

Abstract

BACKGROUND
Severe iron deficiency anemia (IDA) can cause developmental and growth problems in children and disease severity is more than cognitive disorder or diabetic neuropathy according to the disability weight (DW).
METHODS
Severe IDA is defined as serum hemoglobin (Hb) level less than 7.0 g/dL in younger than 4 years of age and less than 8.0 g/dL in older than 5 years, which has been caused by iron deficiency. Among 2,336 patients with IDA, 130 (5.6%) were diagnosed as severe IDA. The exclusion criteria were other hematologic diseases, history of preterm birth or low birth weight and acute blood loss due to trauma.
RESULTS
The rate of severe IDA among IDA patients was higher in female than male. Patients from age 1 to 6 and adolescents over the age of 13 outnumbered others, and the majority of adolescent patients were female. Among weight groups, low weight-for-ages (less than 3rd percentile) was prevail (20%). There were no statistical differences between laboratory results of symptomatic patients and those of asymptomatic ones (25.4%). The common causes of severe IDA were; long-term exclusive breast feeding (13.0%), menorrhagia (10.0%), H. pylori gastritis (9.2%), upper GI bleeding (9.2%) and malnutrition (8.5%). All were treated with oral or intravenous iron replacement therapy and after 3 months, laboratory results were significantly improved. In cases of H. pylori gastritis, iron replacement therapy in conjunction with H. pylori eradication showed better efficacy in treatment.
CONCLUSION
The importance of severe IDA should not be underestimated. Especially with female adolescents, H. pylori gastritis patients, and athletes, it is still more important to make prompt diagnosis and early treatment.