iron Deficiency Anemia: Etiology: Reduced iron intake: Non breastfed infant on cow milk Inadequate intake of iron containing foods Diet containing no bioavailabile iron Reduced iron absorption: Chronic diarrhoea Celiac disease Cow milk allergy G.I surgery Giardiasis Loss of function of TMPRSS6 gene (↓ inhibition of hepcidin) Inadequate transport: Atransferrinemia Anti transferrin receptor antibodies Increased requirement: Periods of growth- preterms, toddlers, puberty Reproductive age female Pregnancy & lactation Increased losses: G.I bleeding Repeated blood sampling Menstruation Intestinal parasites Clinical features: Asymptomatic - most children Pallor - when hb below 7-8g/dl Palms Palmar creases Nail beds Conjunctivae Cold intolerance Fatigue Exercise induced dyspnea Non hematological systemic effects Impaired neurocognitive function in infancy Seizures, strokes, breath-holding spells Pica, pagophagia(ice) Approach to Diagnosis in Nutritional Anemia: Nutritional anemia consists ...
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