Anaemia in children

Haemoglobin reference range:

term (cord 135-195 g/

10-12 years: L

115-145 g/L

Important causes of anaemia in childhood include iron-deficiency anaemia (quite common), thalassaemia major, sickle-cell anaemia and drug-induced haemolysis. Consider one of the haemoglobinopathies in children of Mediterranean, South-East Asian, Arabic or African-American descent, especially with family history, normal ferritin or anaemia resistant to iron therapy. Investigate with Hb electrophoresis.

Drugs that can cause haemolysis (the film will have reticulocytosis, spherocytosis and fragmented red cells) include some antibiotics, e.g. sulfamethoxazole, antimalarials and some antiinflammatories. Think of anaemia in adolescents, especially females with a rapid growth spurt at the menarche and a relatively poor diet.

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