Children anemia knowledge great literacy! Several common causes of anemia in children
Children anemia knowledge great literacy! Several common causes of anemia in children
Anemia is a common symptom or syndrome in children. Anemia can be divided into four degrees of mild, moderate, severe and extremely severe according to the number of peripheral blood globin or red blood cells. Due to the variety of etiology and pathogenesis of anemia, so far, there is no unified classification that can not only clarify the etiology and pathogenesis, but also guide clinical. At present, morphological classification and etiological classification are generally adopted.
1. Etiological classification
This classification method is classified according to the causes of the occurrence of diseases, so it has certain guiding significance for diagnosis and treatment. The cause of anemia is due to the imbalance between the production and destruction of red blood cells, according to which anemia is divided into three categories of hemorrhagic, hemolytic and hematopoietic dysplasia:
(1) Hemorrhagic loss
Acute blood loss: such as traumatic hemorrhage, hemorrhagic disease, etc.
Chronic blood loss: such as ulcer disease, hookworm disease, intestinal polyps, etc.
(2) Hemolytic
Abnormalities in red blood cells (endogenous)
(1) red cell membrane defects: such as hereditary spherocytosis, hereditary oval cytosis.
(2) Red blood cell enzyme defects: such as 6-phosphate glucose dehydrogenase defects, pyruvate kinase defects, etc.
(3) Hemoglobin synthesis and structural abnormalities: such as thalassemia, abnormal hemoglobinopathy, etc.
Extraerythrocyte abnormalities (exogenous)
(1) Immune factors: there are antibodies that destroy red blood cells, such as neonatal hemolytic disease, autoimmune hemolytic anemia, drug-induced immune hemolytic anemia, etc.
(2) Infectious factors: destruction of red blood cells due to hemolysin of bacteria or plasmodium.
(3) Chemical and physical factors: such as benzene, lead, arsenic, snake venom, burns, etc., can directly destroy red blood cells.
(4) Others: such as hypersplenism.
(3) poor hematopoiesis
Deficiency of hematopoietic substances: iron deficiency anemia, nutritional megaloblastic anemia.
Myelosuppression: congenital hypoplastic anemia, aplastic anemia, infection, malignancy, blood diseases, etc.
The above two classification methods have their own advantages and disadvantages. At present, etiological classification is widely used at home and abroad. Since morphological classification can be used to infer etiology, it plays an auxiliary role in etiology diagnosis. Therefore, they can complement each other.
Second, morphological classification
This classification is based on the results of the average volume of red blood cells (MCV, normal value of 80 to 94 cubic microns), the average hemoglobin volume of red blood cells (MCH, normal value of 27 to 32 micrograms) and the average hemoglobin concentration of red blood cells (MCHC, normal value of 32 to 38 grams/dL of red blood cells), anemia is divided into four categories:
(A) Large cell anemia: MCV> 94 cubic microns, MCH is > 32 micrograms. MCHC is normal. People who belong to this type of anemia have nutritional megaloblastic anemia.
(--) Positive cell anemia: MCV, MCH and MCHC were normal. This kind of anemia is seen in aplastic anemia, anemia after acute blood loss.
(3) Simple small cell anemia: MCV is < 80 cubic microns, MCH less than normal, MCHC normal. Anemia caused by chronic infection and chronic kidney disease belongs to this category.
(4) Small cell hypochromic anemia: MCV< 80 cubic microns, MCH of 12 ~ 20 micrograms, MCHC< 30 g/dl. Such anemia is seen in iron deficiency anemia, thalassemia and so on.
Several common causes of anemia in children
Causes of physiologic anemia:
After birth, oxygen saturation increases from 50% to 95%, and red blood cells are destroyed extensively.
Erythropoietin production is suppressed, rapidly declining from high levels at birth to almost undetectable levels, and is disproportionate to the extent of anaemia.
Red blood cell life is short.
Growth is rapid, blood volume expands and red blood cells are diluted.
When hemoglobin is at its lowest, red blood cell production restarts and is maintained until the first year of life. The iron stored in the body of normal full-term infants is sufficient for the synthesis of hemoglobin within 5 months of birth. Iron supplementation during this period does not prevent hemoglobin decline, but only increases storage for later use. Physiological anemia of full-term infants generally does not need treatment, and iron supplementation is ineffective. Physiological anemia in preterm infants is often symptomatic and is considered non-physiological and often requires treatment (see preterm anemia, section 2 of this chapter).
Causes of pathological anemia:
Hypoerythropoietic anemia, congenital pure red cell regeneration disorder, infection, acquired, congenital nutritional defects (iron, folic acid), congenital leukemia.
Hemorrhagic anemia.
Red blood cell destructive anemia.
Anemia is a common symptom or syndrome in children. Anemia can be divided into four degrees of mild, moderate, severe and extremely severe according to the number of peripheral blood globin or red blood cells. Due to the variety of etiology and pathogenesis of anemia, so far, there is no unified classification that can not only clarify the etiology and pathogenesis, but also guide clinical. At present, morphological classification and etiological classification are generally adopted.
1. Etiological classification
This classification method is classified according to the causes of the occurrence of diseases, so it has certain guiding significance for diagnosis and treatment. The cause of anemia is due to the imbalance between the production and destruction of red blood cells, according to which anemia is divided into three categories of hemorrhagic, hemolytic and hematopoietic dysplasia:
(1) Hemorrhagic loss
Acute blood loss: such as traumatic hemorrhage, hemorrhagic disease, etc.
Chronic blood loss: such as ulcer disease, hookworm disease, intestinal polyps, etc.
(2) Hemolytic
Abnormalities in red blood cells (endogenous)
(1) red cell membrane defects: such as hereditary spherocytosis, hereditary oval cytosis.
(2) Red blood cell enzyme defects: such as 6-phosphate glucose dehydrogenase defects, pyruvate kinase defects, etc.
(3) Hemoglobin synthesis and structural abnormalities: such as thalassemia, abnormal hemoglobinopathy, etc.
Extraerythrocyte abnormalities (exogenous)
(1) Immune factors: there are antibodies that destroy red blood cells, such as neonatal hemolytic disease, autoimmune hemolytic anemia, drug-induced immune hemolytic anemia, etc.
(2) Infectious factors: destruction of red blood cells due to hemolysin of bacteria or plasmodium.
(3) Chemical and physical factors: such as benzene, lead, arsenic, snake venom, burns, etc., can directly destroy red blood cells.
(4) Others: such as hypersplenism.
(3) poor hematopoiesis
Deficiency of hematopoietic substances: iron deficiency anemia, nutritional megaloblastic anemia.
Myelosuppression: congenital hypoplastic anemia, aplastic anemia, infection, malignancy, blood diseases, etc.
The above two classification methods have their own advantages and disadvantages. At present, etiological classification is widely used at home and abroad. Since morphological classification can be used to infer etiology, it plays an auxiliary role in etiology diagnosis. Therefore, they can complement each other.
Second, morphological classification
This classification is based on the results of the average volume of red blood cells (MCV, normal value of 80 to 94 cubic microns), the average hemoglobin volume of red blood cells (MCH, normal value of 27 to 32 micrograms) and the average hemoglobin concentration of red blood cells (MCHC, normal value of 32 to 38 grams/dL of red blood cells), anemia is divided into four categories:
(A) Large cell anemia: MCV> 94 cubic microns, MCH is > 32 micrograms. MCHC is normal. People who belong to this type of anemia have nutritional megaloblastic anemia.
(--) Positive cell anemia: MCV, MCH and MCHC were normal. This kind of anemia is seen in aplastic anemia, anemia after acute blood loss.
(3) Simple small cell anemia: MCV is < 80 cubic microns, MCH less than normal, MCHC normal. Anemia caused by chronic infection and chronic kidney disease belongs to this category.
(4) Small cell hypochromic anemia: MCV< 80 cubic microns, MCH of 12 ~ 20 micrograms, MCHC< 30 g/dl. Such anemia is seen in iron deficiency anemia, thalassemia and so on.
Several common causes of anemia in children
Causes of physiologic anemia:
After birth, oxygen saturation increases from 50% to 95%, and red blood cells are destroyed extensively.
Erythropoietin production is suppressed, rapidly declining from high levels at birth to almost undetectable levels, and is disproportionate to the extent of anaemia.
Red blood cell life is short.
Growth is rapid, blood volume expands and red blood cells are diluted.
When hemoglobin is at its lowest, red blood cell production restarts and is maintained until the first year of life. The iron stored in the body of normal full-term infants is sufficient for the synthesis of hemoglobin within 5 months of birth. Iron supplementation during this period does not prevent hemoglobin decline, but only increases storage for later use. Physiological anemia of full-term infants generally does not need treatment, and iron supplementation is ineffective. Physiological anemia in preterm infants is often symptomatic and is considered non-physiological and often requires treatment (see preterm anemia, section 2 of this chapter).
Causes of pathological anemia:
Hypoerythropoietic anemia, congenital pure red cell regeneration disorder, infection, acquired, congenital nutritional defects (iron, folic acid), congenital leukemia.
Hemorrhagic anemia.
Red blood cell destructive anemia.
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