Anemia

A reduced number of red blood cells may be caused by:

• Decreased production of red blood cells in the bone marrow. Examples of decreased production of red blood cells in the bone marrow include:
  • Underlying bone marrow failures like Diamond-Blackfan anemia (DBA) and aplastic anemia
  • Inherited problems, such as thalassemia, that interfere with the normal production of hemoglobin
  • Acquired nutritional deficiencies such as iron or folate deficiency
• Early or increased destruction of red blood cells. Examples of early or increased destruction of red blood cells include:
  • Sickle cell disease due to the problems with making hemoglobin
  • Hereditary spherocytosis due to problems with the red blood cell membrane
  • Glucose-6-phosphate dehydrogenase deficiency, which results in a shortened red blood cell lifespan
  • A malfunction of the immune system that makes antibodies attack the body’s own red blood cells (autoimmune)
• Sequestration. This means the red blood cells are going into spaces within the body instead of remaining in the circulating bloodstream that goes to the lungs and heart. A common place for sequestration to occur is the spleen.

Other causes of anemia include blood loss, severe inflammation, thyroid problems, kidney disease, recurrent infections, celiac disease and, rarely, cancer.

Anyone can have anemia. There are more than 3 million people with the condition in the U.S. The most common type of anemia is iron-deficiency anemia, which frequently affects women due to menstruation and children (especially toddlers). Anemia is not contagious.

There are many causes of anemia. Some types of anemia are inherited, but most are acquired. Inherited causes of anemia usually imply that an individual will always have anemia unless he or she receives special treatments. This may or may not affect the individual’s lifespan. Acquired types of anemia go away when the underlying problem goes away. For example, if anemia is caused by a poor diet, then diet modification and sometimes supplements will resolve the anemia. If the anemia is caused by excessive bleeding, then evaluation for a bleeding disorder and its correction would be necessary to resolve the anemia. Acquired types of anemia that are treated usually do not affect an individual’s lifespan, and individuals may be able to donate blood in the future without problems.

Symptoms of anemia vary depending on the cause but may include:

• Fatigue
• Shortness of breath
• Dizziness
• Headache
• Weakness
• Pale skin
• Yellow skin (jaundice), if there are many red blood cells dying too quickly
• Fast or irregular heartbeat
• Difficulties thinking
• Irritability
• Desire to chew or eat substances such as ice, dirt, clay, sand, metal, paper or chalk (symptoms of pica)

The presence and intensity of symptoms parallel the severity of the anemia.

Diagnosis of Anemia

Doctors at Riley at IU Health diagnose anemia by reviewing your child's medical history, conducting a thorough examination and performing a blood test.

Additional tests may be needed to determine what type of anemia your child has. These additional tests are usually blood tests but could possibly include a bone marrow test because the bone marrow is where red blood cells are made. Additional testing may also include imaging studies.