A Study of Severe Anemia in Children in a Tertiary Care Institute

Introduction: The present study was to emphasize the chief causative factors, clinical manifestations, various hematological and morphological types in children with severe anemia, admitted to the pediatric wards of a tertiary care hospital. Objectives: The primary objective was to study clinical profile of severe anemia in children with various risk factor and hematological parameters among children with severe anemia. Methods: This was an observational study conducted in a tertiary health care institute. Children with severe anemia satisfying eligibility criteria with Hb less than or equal to 7gm/dl in age group 6 Month to 59 months. Less than or equal to 8gm/dl in age group 5 years to 14 years were included. Associated complaints and Clinical features were studied. Complete blood cell count with RBC indices- MCV, MCH and MCHC peripheral smear examination, reticulocyte count, stool examination, urine examination and Mantoux test were done in all patients. Serum ferritin, Hb electrophoresis, bone marrow examination, liver function test and renal function test, and x ray, U.S.G. abdomen, CT scan in relevant cases were done. Result: In this series 59 patients were included. Incidence of severe anemia was more in < 3.5 years age group (50.85%). Male to female ratio was 1.45:1. Out of 59 cases studied, 47(79.66%) had varying degrees of malnutrition. Pallor is the most prominent and characteristic sign noted in 59 cases (100%). Nutritional anemia was most common in 32 cases (55.93%) out of which 28 were microcytic and 4 were dimorphic. Associated infections were noted in 35 cases (59.32%). Conclusion: Nutritional deficiency is the most common cause of severe anemia especially iron deficiency anemia. Most of the children were malnourished and had infection indicating that severe anemia is directly related to malnutrition and infection. Pallor is the most consistent clinical sign of severe anemia. Severe anemia is more common in children aged < 3.5 years.