Research Article
BibTex RIS Cite

Derin Çocukluk Çağı Anemisinin Değerlendirilmesi ve Yönetimi: Tek Merkez Deneyimi

Year 2020, Volume: 22 Issue: 1, 46 - 50, 30.04.2020

Hatice Mine Çakmak Mehmet Ali Sungur Kenan Kocabay

https://doi.org/10.18678/dtfd.660893

Abstract

Amaç: Bu çalışmanın amacı derin anemisi olan hastalarda demir eksikliği anemisi sıklığını belirlemek ve demir eksikliği anemisi olan ve olmayan hastalar arasında hematolojik parametrelerdeki farklılığı incelemek ve karşılaştırmaktır.
Gereç ve Yöntemler: Bu çalışmada Ocak 2012 ve Temmuz 2014 tarihleri arasında derin anemi tanısı almış olan toplam 119 hasta geriye dönük olarak incelendi. Derin anemi hastalarının demografik ve klinik özellikleri değerlendirildi. Hastalar demir eksikliği anemisi açısından değerlendirildi ve demir eksikliği anemisi olan ve olmayan hastaların klinik özellikleri ve laboratuvar bulguları karşılaştırıldı.
Bulgular: Yüz on dokuz olgunun 49 (%41,2)’u erkek, 70 (%58,8)’i kız olup ortalama yaş 6,7±6,2 yıl idi. Hastalarda çeşitli eş zamanlı hastalıklar vardı. Tüm hastalarda, hemoglobin değeri 6 gr/dL’nin altında olan grup, 6 gr/dL’ye eşit ve üstünde olanlara göre anlamlı şekilde daha düşük trombosit sayısına sahipti (p=0,037). Tüm vakaların 52 (%43,7)’sinde demir eksikliği anemisi olduğu bulundu ve bunların 27 (%51,9)’si 5 ile 18 yaş arasında idi. Demir eksikliği anemisi olan hastaların ferritin düzeyi demir eksikliği anemisi olmayan hastalara göre daha düşük (p<0,001) iken, trombosit sayısı ise demir eksikliği anemisi olan hastalarda daha yüksekti (p=0,001).
Sonuç: Derin anemili hastalarda, hemoglobin değerinin 6 g/dL’nin altında olması durumunda trombosit sayısında anlamlı düşüş saptanmıştır. Eritrosit transfüzyonu ihtiyacını azaltmak için, demir eksikliği anemisinin erken teşhisi önemlidir ve demir takviyesi daha erken yapılmalıdır.

Keywords

Derin anemi çocukluk çağı demir eksikliği anemisi kan transfüzyonu

References

  • Brugnara C, Oski FA, Nathan DG. Diagnostic approach to the anemic patient. In: Orkin SH, Nathan DG, Ginsburg D, Look AT, Fisher DE, Lux SE, editors. Nathan and Oski's hematology of infancy and childhood. 7th ed. 7th ed. Philadelphia: WB Saunders; 2009. p.455-66.
  • Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology and etiology in low- and middle-income countries. Ann N Y Acad Sci. 2019;1450(1):15-31.
  • Zimmermann MB, Hurrell RF. Nutritional iron deficiency. Lancet. 2007;370(9586):511-20.
  • van Hensbrock MB, Jonker F, Bates I. Severe acquired anaemia in Africa: new concepts. Br J Haematol. 2011;154(6):690-5.
  • Kline NE. A practical approach to the child with anemia. J Pediatr Healt Care. 1996;10(3):99-105.
  • Kapil U, Tyagi M. Etiology of severe anemia amongst adolescent children. Indian J Pediatr. 2012;79(3):401-2.
  • Dicko A, Klion AD, Théra MA, Sagara I, Yalcouyé D, Niambele MB, et. al. The etiology of severe anemia in a village and periurban area in Mali. Blood. 2004;104(4):1198-200.
  • Bansal D, Totadri S. Common hematological disorders in children. Indian J Pediatr. 2014;81(1):42-50.
  • Güvenç H, Aygün AD, Soylu F, Kocabay K. Çocukluk döneminde derin anemi etyolojisinde demir eksikliğinin önemi. MN Pediatride Yönelişler. 1994;1:149-52.
  • Şimşek Ş, Büyükavcı M, Kaya MD, Akdağ R, Karakelleoğlu C. Anemia prevalance and it's etiologic factors in patients admitted to pediatric outpatients departments living moderately high altitude in Erzurum. Zeynep Kamil Tıp Bülteni. 2005;36(1):33-8.
  • Kılıçaslan Ö, Yıldırmak ZY, Urgancı N. Evaluation of patients hospitalised in pediatrics clinic for profound anemia and diagnosed as iron deficiency. Med Bull Sisli Etfal Hosp. 2014;48(3):234-8.
  • Alvarez-Uria G, Naik PK, Midde M, Yalla PS, Pakam R. Prevalence and severity of anaemia stratified by age and gender in rural India. Anemia. 2014;176182.
  • Kwiatkowski JL, West TB, Heidary N, Smith-Whitley K, Cohen AR. Severe iron deficiency anemia in young children. J Pediatr. 1999;135(4):514-6.
  • Paoletti G, Bogen DL, Ritchey AK. Severe iron-deficiency anemia still an issue in toddlers. Clin Pediatr (Phila). 2014;53(14):1352-8.
  • İnci Yıldız. Iron deficiency anemia. Turk Pediatri Ars. 2009;44(1):14-8.
  • Morris VK, Spraker HL, Howard SC, Ware RE, Reiss UM. Severe thrombocytopenia with iron deficiency anemia. Pediatr Hematol Oncol. 2010;27(5):413-9.
  • Reeve K, Jones H. Transfusion guidelines in children: I. Anaesth Intens Care Med. 2017;18(11):541-5.
  • Jones H, Reeve K. Transfusion guidelines in children: II. Anaesth Intens Care Med. 2017;18(11):546-50.
  • Keskin A, Polat A, Türk T, Sermez Y. The importance of red cell distribution width (RDW) in the early diagnosis of iron deficiency. Med Bull Haseki. 2000;38(2):119-21.

Evaluation and Management of Severe Childhood Anemia: A Single Center Experience

Year 2020, Volume: 22 Issue: 1, 46 - 50, 30.04.2020

Hatice Mine Çakmak Mehmet Ali Sungur Kenan Kocabay

https://doi.org/10.18678/dtfd.660893

Abstract

Aim: The aim of this study was to determine the frequency of iron deficiency anemia in patients with severe anemia, and to investigate and compare the difference in the hematological parameters between patients with and without iron deficiency anemia.
Material and Methods: A total of 119 patients diagnosed with severe anemia between January 2012 and July 2014 were retrospectively analyzed in this study. Demographic and clinical characteristics of severe anemia patients were evaluated. Patients were evaluated in terms of iron deficiency anemia, and clinical characteristic and laboratory findings of the patients with and without iron deficiency anemia were compared.
Results: Of the 119 cases 49 (41.2%) were male and 70 (58.8%) were female, mean age was 6.7±6.2 years. Various comorbidities were present in the patients. In all patients, the group with a hemoglobin value below 6 g/dL had a significantly lower platelet count than those equal to or above 6 g/dL (p=0.037). It was found that 52 (43.7%) of all cases had iron deficiency anemia and 27 (51.9%) of them were aged 5 to 18 years. Patients with iron deficiency anemia had lower ferritin level (p<0.001) than patients without iron deficiency anemia, while platelet count was higher in patients with iron deficiency anemia (p=0.001).
Conclusion: In patients with severe anemia, a significant decrease in platelet count was found with hemoglobin value below 6 g/dL. In order to reduce the need for red blood cells transfusion, early diagnosis of iron deficiency anemia is important and iron supplementation should be given earlier.

Keywords

Severe anemia childhood iron deficiency anemia blood transfusion

References

  • Brugnara C, Oski FA, Nathan DG. Diagnostic approach to the anemic patient. In: Orkin SH, Nathan DG, Ginsburg D, Look AT, Fisher DE, Lux SE, editors. Nathan and Oski's hematology of infancy and childhood. 7th ed. 7th ed. Philadelphia: WB Saunders; 2009. p.455-66.
  • Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology and etiology in low- and middle-income countries. Ann N Y Acad Sci. 2019;1450(1):15-31.
  • Zimmermann MB, Hurrell RF. Nutritional iron deficiency. Lancet. 2007;370(9586):511-20.
  • van Hensbrock MB, Jonker F, Bates I. Severe acquired anaemia in Africa: new concepts. Br J Haematol. 2011;154(6):690-5.
  • Kline NE. A practical approach to the child with anemia. J Pediatr Healt Care. 1996;10(3):99-105.
  • Kapil U, Tyagi M. Etiology of severe anemia amongst adolescent children. Indian J Pediatr. 2012;79(3):401-2.
  • Dicko A, Klion AD, Théra MA, Sagara I, Yalcouyé D, Niambele MB, et. al. The etiology of severe anemia in a village and periurban area in Mali. Blood. 2004;104(4):1198-200.
  • Bansal D, Totadri S. Common hematological disorders in children. Indian J Pediatr. 2014;81(1):42-50.
  • Güvenç H, Aygün AD, Soylu F, Kocabay K. Çocukluk döneminde derin anemi etyolojisinde demir eksikliğinin önemi. MN Pediatride Yönelişler. 1994;1:149-52.
  • Şimşek Ş, Büyükavcı M, Kaya MD, Akdağ R, Karakelleoğlu C. Anemia prevalance and it's etiologic factors in patients admitted to pediatric outpatients departments living moderately high altitude in Erzurum. Zeynep Kamil Tıp Bülteni. 2005;36(1):33-8.
  • Kılıçaslan Ö, Yıldırmak ZY, Urgancı N. Evaluation of patients hospitalised in pediatrics clinic for profound anemia and diagnosed as iron deficiency. Med Bull Sisli Etfal Hosp. 2014;48(3):234-8.
  • Alvarez-Uria G, Naik PK, Midde M, Yalla PS, Pakam R. Prevalence and severity of anaemia stratified by age and gender in rural India. Anemia. 2014;176182.
  • Kwiatkowski JL, West TB, Heidary N, Smith-Whitley K, Cohen AR. Severe iron deficiency anemia in young children. J Pediatr. 1999;135(4):514-6.
  • Paoletti G, Bogen DL, Ritchey AK. Severe iron-deficiency anemia still an issue in toddlers. Clin Pediatr (Phila). 2014;53(14):1352-8.
  • İnci Yıldız. Iron deficiency anemia. Turk Pediatri Ars. 2009;44(1):14-8.
  • Morris VK, Spraker HL, Howard SC, Ware RE, Reiss UM. Severe thrombocytopenia with iron deficiency anemia. Pediatr Hematol Oncol. 2010;27(5):413-9.
  • Reeve K, Jones H. Transfusion guidelines in children: I. Anaesth Intens Care Med. 2017;18(11):541-5.
  • Jones H, Reeve K. Transfusion guidelines in children: II. Anaesth Intens Care Med. 2017;18(11):546-50.
  • Keskin A, Polat A, Türk T, Sermez Y. The importance of red cell distribution width (RDW) in the early diagnosis of iron deficiency. Med Bull Haseki. 2000;38(2):119-21.
There are 19 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Hatice Mine Çakmak 0000-0003-3730-0982

Mehmet Ali Sungur 0000-0001-5380-0819

Kenan Kocabay 0000-0002-4030-1145

Publication Date April 30, 2020
Submission Date December 18, 2019
Published in Issue Year 2020 Volume: 22 Issue: 1

Cite

APA Çakmak, H. M., Sungur, M. A., & Kocabay, K. (2020). Evaluation and Management of Severe Childhood Anemia: A Single Center Experience. Duzce Medical Journal, 22(1), 46-50. https://doi.org/10.18678/dtfd.660893
AMA Çakmak HM, Sungur MA, Kocabay K. Evaluation and Management of Severe Childhood Anemia: A Single Center Experience. Duzce Med J. April 2020;22(1):46-50. doi:10.18678/dtfd.660893
Chicago Çakmak, Hatice Mine, Mehmet Ali Sungur, and Kenan Kocabay. “Evaluation and Management of Severe Childhood Anemia: A Single Center Experience”. Duzce Medical Journal 22, no. 1 (April 2020): 46-50. https://doi.org/10.18678/dtfd.660893.
EndNote Çakmak HM, Sungur MA, Kocabay K (April 1, 2020) Evaluation and Management of Severe Childhood Anemia: A Single Center Experience. Duzce Medical Journal 22 1 46–50.
IEEE H. M. Çakmak, M. A. Sungur, and K. Kocabay, “Evaluation and Management of Severe Childhood Anemia: A Single Center Experience”, Duzce Med J, vol. 22, no. 1, pp. 46–50, 2020, doi: 10.18678/dtfd.660893.
ISNAD Çakmak, Hatice Mine et al. “Evaluation and Management of Severe Childhood Anemia: A Single Center Experience”. Duzce Medical Journal 22/1 (April 2020), 46-50. https://doi.org/10.18678/dtfd.660893.
JAMA Çakmak HM, Sungur MA, Kocabay K. Evaluation and Management of Severe Childhood Anemia: A Single Center Experience. Duzce Med J. 2020;22:46–50.
MLA Çakmak, Hatice Mine et al. “Evaluation and Management of Severe Childhood Anemia: A Single Center Experience”. Duzce Medical Journal, vol. 22, no. 1, 2020, pp. 46-50, doi:10.18678/dtfd.660893.
Vancouver Çakmak HM, Sungur MA, Kocabay K. Evaluation and Management of Severe Childhood Anemia: A Single Center Experience. Duzce Med J. 2020;22(1):46-50.
 Download Cover Image
Creative Commons License
Duzce Medical Journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.