Iron deficiency anemia in children
The content of the article:
- Causes
- Signs
- Diagnostics
- Treatment
- Prevention
- Consequences and complications
Iron deficiency anemia in children is a clinical and laboratory syndrome that develops as a result of insufficient iron content in the child's body and manifests itself in a violation of the formation of hemoglobin and hypoxic disorders.
The pathology is widespread: it is diagnosed in 40% of children in the first years of life and in 30% of adolescents.
Iron deficiency anemia occurs in 40% of children in the first years of life
Causes
Antenatal and postnatal factors can lead to iron deficiency anemia in children.
Under the influence of antenatal factors in the prenatal period of development, there is no creation of an iron depot sufficient in its reserves, which becomes the cause of iron deficiency anemia in children of the first 18 months of life. These factors include:
- iron deficiency anemia in a pregnant woman;
- severe toxicosis of the first and second half of pregnancy;
- fetoplacental insufficiency;
- multiple pregnancy;
- placental abruption;
- late or premature umbilical cord ligation in a child;
- prematurity;
- a large body weight in a child at birth.
Early iron deficiency anemia is most often detected in children with lymphatic-hypoplastic diathesis.
In children with lymphatic-hypoplastic diathesis, iron deficiency anemia is common
The main postnatal factor that determines the development of iron deficiency anemia is irrational feeding of the child, which leads to insufficient intake of iron in his body. The risk group includes children who are artificially fed with cow or goat milk, unadapted milk formulas. Other reasons for the formation of an iron deficiency state can be:
- late introduction of complementary foods;
- insufficient content in the diet (in children of any age) of animal protein, vitamins and microelements.
More rare causes of iron deficiency anemia in children:
- profuse menstruation in adolescent girls;
- profuse external and internal bleeding;
- celiac disease;
- lactose deficiency;
- cystic fibrosis;
- ulcerative colitis,
- Crohn's disease;
- enteritis;
- Hirschsprung's disease;
- intestinal dysbiosis;
- giardiasis;
- intestinal infections.
Signs
The clinical picture of iron deficiency anemia in children is usually not very specific, it is dominated by one of the following syndromes:
- Asthenovegetative syndrome. Its development is associated with hypoxia of organs and tissues of the body - first of all, the central nervous system. The child has muscle weakness, and in severe cases, delayed psychomotor development. Other manifestations of asthenovegetative syndrome include irritability, tearfulness, frequent fainting, enuresis.
- Epithelial Syndrome. Its development is based on changes in both the skin itself and its appendages. Children’s nails become brittle, hair loses its shine and actively falls out. Cracks appear on the mucous membrane of the mouth, cheilitis and glossitis often develop.
- Dyspeptic syndrome. It is characterized by a lack of appetite, flatulence, unstable stools.
- Cardiovascular syndrome. Develops against the background of severe iron deficiency anemia. The child develops tachycardia, shortness of breath, cyanosis of the skin, and blood pressure decreases. With a long course of the disease in the myocardium, dystrophic changes may begin.
- Immunodeficiency syndrome. Clinically manifested by frequent respiratory and (or) intestinal infectious diseases, prolonged "causeless" subfebrile condition.
- Hepatolienal syndrome. It is characterized by an enlarged liver and spleen (hepatosplenomegaly).
Brittle nails in a child are one of the signs of iron deficiency anemia
Diagnostics
Diagnosis of iron deficiency anemia in children is carried out according to the results of laboratory tests. The following changes are characteristic:
- hemoglobin - below 110 g / l;
- color index - less than 0.86;
- the iron content in blood serum is less than 14 μmol / l;
- serum ferritin - below 12 μg / l;
- total iron-binding capacity of blood plasma - over 63.
In order to establish the cause that caused the development of iron deficiency anemia, if necessary, conduct other laboratory and instrumental studies:
- FEGDS;
- ultrasound examination of the abdominal and pelvic organs;
- colonoscopy;
- irrigoscopy;
- X-ray of the stomach with contrast;
- study of feces for occult blood, protozoa and helminth eggs.
Treatment
Therapy for iron deficiency anemia in children is based on the following principles:
- elimination of the cause that caused the development of iron deficiency;
- nutritional correction;
- the appointment of iron-containing drugs.
Correction of the child's nutrition is a mandatory stage in the treatment of iron deficiency anemia
In the diet of children suffering from iron deficiency anemia, it is necessary to include in sufficient quantities iron-rich foods:
- apples, peaches;
- spinach;
- oatmeal, buckwheat;
- legumes;
- egg yolk;
- fish;
- beef, veal;
- liver, tongue.
Medical correction of iron deficiency is carried out by the appointment of iron preparations. With anemia of mild and moderate severity, they are prescribed orally (in the form of syrups, suspensions, tablets). In severe anemia, it may be necessary to inject iron preparations (intramuscularly or intravenously). Also, in severe iron deficiency anemia, in some cases, blood transfusion is indicated.
The duration of drug therapy for iron deficiency anemia in children is 4-6 weeks. After the normalization of the hemoglobin level, the drugs continue to be taken in maintenance doses for 2-3 months.
Prevention
Prevention of iron deficiency anemia can be divided into antenatal and postnatal.
Antenatal prophylaxis includes the following measures:
- rational management of pregnancy and childbirth;
- correction of iron deficiency in a pregnant woman;
- proper and rational nutrition of a pregnant woman.
Postnatal prevention of iron deficiency anemia in children is based on the following principles:
- organization of breastfeeding;
- timely introduction of age-appropriate complementary foods;
- proper childcare.
Prevention of iron deficiency anemia in children should begin at the stage of pregnancy
With an increased risk of developing iron deficiency anemia, children are periodically prescribed preventive courses of treatment with iron-containing drugs. The risk group includes:
- Twins;
- premature babies;
- children with manifestations of constitutional anomalies (diathesis);
- children who are in a period of especially rapid growth;
- teenage girls with heavy periods.
Consequences and complications
Against the background of iron deficiency anemia in children, the content of immunoglobulins in the blood decreases, as a result of which they often begin to suffer from various infectious and somatic diseases.
Severe iron deficiency anemia in early childhood in the absence of timely adequate treatment can lead to a delay in psychomotor development.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
