Anemia, Iron Deficiency

Anemia, Iron Deficiency



Jill S. Halterman, MD, MPH , George B. Segel, MD



Basic Information



Definition


Iron deficiency anemia is caused by insufficient iron for the normal formation of hemoglobin.



ICD-9-CM Codes



280.9 Iron deficiency anemia, unspecified


Epidemiology & Demographics



• Iron deficiency is the most prevalent hematologic disorder in childhood.

• Affects 5% to 10% of infants.

• Infants who consume large amounts of cow’s milk as well as foods not supplemented with iron may develop dietary iron deficiency.

• Cow’s milk contains essentially no iron.

• Excessive intake of cow’s milk impairs adequate intake of other foods rich in iron.

• Proteins in the cow’s milk may cause bleeding from irritation of the gastrointestinal (GI) tract in infants, compounding iron deficiency.

• The small amount of iron in breast milk is absorbed efficiently but is not sufficient for the growing infant after 6 months.


Clinical Presentation



History



• Pallor may be apparent.

• When anemia is severe (hemoglobin < 5 g/dL), of irritability, anorexia, and exertional intolerance, reflect the systemic effects of iron deficiency.

• Pica may include consumption of laundry starch, ice, and soil clay.

• Iron deficiency with or without concomitant anemia impairs growth and intellectual development in children.


Physical Examination



• Tachycardia, pallor, irritability, systolic murmur, growth failure, developmental delay


Etiology



• Iron deficiency may be caused by insufficient dietary intake, GI or other bleeding, or rarely, chronic intravascular hemolysis and urinary iron loss.

• Iron deficiency is common from 9 to 24 months of age because iron stores are depleted during periods of accelerated growth.

• Adolescent girls also may develop iron deficiency because of poor dietary intake, high iron requirements related to rapid growth, and menstrual blood loss.

• Blood loss must be considered, particularly in the older child who is likely to have adequate dietary intake.
image The most common location for blood loss is the GI tract.

image Rarely, iron loss may result from bleeding into the lungs (idiopathic pulmonary hemosiderosis or Goodpasture’s syndrome) or urinary tract.
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Jul 2, 2016 | Posted by in PEDIATRICS | Comments Off on Anemia, Iron Deficiency

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