What is chronic anemia?
Blood is made up of red blood cells, white blood cells, platelets and plasma. Hemoglobin is an iron-rich protein in the red blood cells that helps the red blood cells carry oxygen from the lungs to the rest of the body. Anemia is a blood disorder where there aren’t enough red blood cells or hemoglobin in these red blood cells.
Anemia may be caused by the red blood cells being destroyed at a higher-than-normal rate, decreased production of red blood cells in the bone marrow, blood loss or the production of red blood cells that do not contain enough hemoglobin. Many types of anemia are mild and easily treated. Other types can cause more serious problems.
What are the symptoms of anemia?
Mild forms of anemia may have very few symptoms because the body is able to compensate for mild anemia. Most of the symptoms of anemia that do occur are caused by a decreased ability of the blood to carry oxygen to different parts of the body. The most common anemia symptom is fatigue or a decrease in energy level.
Other anemia symptoms may include:
- Increased heart rate
- Irregular menstrual periods or in some cases absent or delayed menstruation in girls
- Leg pain or leg sores
- Pale skin, lips, or hands (nail bed)
- Shortness of breath, or difficulty catching one’s breath during exercise
- Swollen appearance of the abdomen, enlarged liver or spleen or pain in the upper part of the abdomen
- Sore or swollen tongue
- Yellowish tint to the eyes or skin
- Anemia can resemble other blood disorders and sometimes anemia can be a symptom of another medical condition. Always keep your physician informed about the symptoms your child is experiencing.
How is anemia diagnosed?
When anemia is suspected, it is very important that a physician take a complete history and perform a physical examination. This will provide valuable information about possible causes of the anemia as well as its effect on the body.
Blood tests that are often performed when a child is being evaluated for anemia include a hemoglobin, hematocrit and reticulocyte count. A blood smear is examined under a microscopic to look at the number size and shape of red blood cells.
Other blood tests that may be obtained include a hemoglobin electrophoresis (to look for abnormal hemoglobin), red blood cell enzyme levels (a cause of hemolytic anemia), direct and indirect coombs (autoimmune hemolytic anemia), osmotic fragility (assessing the red blood cell membrane), iron and vitamin levels (important in red blood cell production), and a bone marrow test (to evaluate production of red blood cells in the bone marrow.)
What are the different types of anemia?
There are many different causes of anemia. Some are inherited and others are acquired. Some are related to dietary deficiency, blood loss, an abnormal immune system, bone marrow failure, medication, renal disease, or other conditions. Some of the more common types of anemia are:
- Chronic anemia
- Hemolytic anemia
- Hereditary spherocytosis
- Hemoglobinopathies, including sickle cell anemia, thalasemia, aplastic and hypoplastic anemia
- Iron deficiency anemia
- Megaloblastic anemia
How is anemia treated?
Treatment for anemia depends on what is causing the anemia and how severe it is. The first step in treating a child with anemia is finding out what the cause is. Mild forms of anemia may require only observation. Other times, anemia may require a variety of treatments, such as changes in diet, vitamin and mineral supplements, medications or transfusion.
Serious forms of anemia require lifelong treatment that may include blood transfusions, medication and, in rare situations, bone marrow transplantation.
Children’s hematology team will work with you to determine the cause of your child’s anemia and then to create the best treatment plan for your child’s unique needs and circumstances.
About treatment for anemia at Children’s
Children’s Cancer and Blood Disorders program achieves outcomes that rank among the top national programs and cares for more than two-thirds of Minnesota children and adolescents with blood disorders. In the program, families coping with anemia have access to the newest and most promising treatments and receive care spearheaded and coordinated by a board-certified hematologist/oncologist.
If you are a family member looking for a Children’s hematologist or oncologist or wanting to schedule an appointment, call the outpatient clinic at Children’s – Minneapolis at 612-813-5940.
If you are a health professional looking for a consultation or referral information, please call Children’s Physician Access at 1-866-755-2121 (toll-free).