Anemia

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Anemia occurs when the level of red blood cells or hemoglobin in the blood is too low, which can cause fatigue and stress on organs. It can be caused by excessive red blood cell destruction, blood loss, or inadequate red blood cell production. Common causes include iron deficiency, blood loss, and inherited disorders like sickle cell anemia or thalassemia. Symptoms include paleness and fatigue. Diagnosis involves blood tests, and treatment depends on the underlying cause but may include iron supplements, blood transfusions, or medications.

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Anemia can be seen in the emergency department both as a primary pathological process or secondary to both medical and surgical diseases. Moreover, acute anemia can occur in children who have been otherwise healthy, who have systemic disease, or who have known hematologic disorders. Anemia may indicate a disorder with a single hematopoietic cell line (eg, red blood cells) or may be associated with changes in multiple cell lines indicative of bone marrow involvement, immunologic disease, peripheral destruction of erythrocytes, or sequestration of cells. Independent of the etiology, prompt diagnosis is predicated on understanding the classifications of anemia, the associated presenting symptoms, and the proper ordering and interpretation of laboratory studies. This article will discuss the evaluation, proper classification, differential diagnosis, and initial management of acute anemia using cases representative of those that might be seen in the pediatric emergency department.

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