› Editor-inChief - International Journal of Paediatric Nephrology and Urology
› Chairman & Managing Director - Nephron Clinic
› Vice Chairman and Director - Manipal Hospital (Dwarka, New Delhi)
› Chairman Medical Advisory Board (MHDPL), Manipal Hospital (Dwarka)
› Head Academics - Manipal Hospital (Dwarka)
Home  >>Treatment  >>Anemia
Follow us on :- Kidney Treatment Clinic In Delhi, Paediatric Nephrology India, Baby Care Centre In Delhi   Renal Stone Treatment In Delhi, Nephrology Treatment In Delhi, Baby Renal Treatment In India


Anemia in infancy and childhoodhas many causes. It is important to find the route cause and to initiate early and acute treatment, for very often anemia can be a typical presentation of a typical disease. 
In anemic child who is iron deficient looks pale, tired, anorexic, with behavioral abnormalities (irritability confusion, with poor attention and learning span). These children also have tachy cardia, heart murmur, palpable spleen, under poor weight gain etc. 
Iron deficiency which is typical in Indian setting go through stages of Iron depletion, iron deficient erythropoiesis, and then iron deficiency. 
Complete and often extensive investigations are required for children which have multisystemic presentation with anemia. The following tabulations give a simple approach to a patient with anemia.   
**Diagnosis of anemia : erythrocyte forms in blood smears
Normal form
Anosocytosis                         Anemias                                                                                               
Poilkilocytosis                       Severe anemias
Hemolytic anemia with macro- or microangiopathy, e.g. hemolytie uremic syndrome (HUS)
Hereditary pyropoikilocytosis
Hereditary elliptocytosis of neonates
Anulocytes                             Hyperchromic anemia
Microspherocytes                 Hereditary spherocytosis
Elliptocytes                            Hereditary elliptocytosis, thalassemia, megaloblastic anemia
Sickle cells                            Sickle cell anemia
Target cells                            Hypochromic anemia, β thalassemias,  hemoglobin C disease
**Biological errors that may be the cause of primarily reduced measurements
Variation in result
Upwards (false positive)         Downwards (false negative)
Erythrocyte count
High leukocytosis
Platelet aggregation
Marked microcytosis
(+ fragmentation)
Agglutination (counted as leukocytes)
Leukocyte count
Platelet aggregation
Agglutination of the leukocytes
Platelet count
Lipid infusion
Platelet Aggregation
Platelet adhesion
In vivo hemolysis
Hyperglycemia (Osmolality)
1) Severe anemia may require blood transfusion
2) Moderate to low anemias require oral supplementation of iron and vitamins. The dose is calculated with regards the body weight of the child. (3 ml / kg per day of elemental iron)
3) Response to therapy begins with decreased irritability and improved appetite within 24 hrs. Followed by an increase in retic count within 3 days. Hemoglobin increased within 5 – 7 days.
4) Patient education, nutritional counseling, ruling out common cause such as pica and warm infestation is important.