Anaemia

Levels of Hb are high at birth, and decrease over time. The reason for this is that, high O2 delivery causes a negative feedback, leading to less EPO production and less Hb.

Causes in infants

• Haemolysis

  • Haemolytic Disease of the Newborn

  • Hereditary spherocytosis (abnormal rbc shape i.e. spherical)

  • G6PD deficiency

• Blood loss

• Anaemia of prematurity

• Twin-twin transfusion – Blood unequally distributed between twins in womb

Causes in older children

The most common cause here is dietary insufficiency.

Other less common causes include:

• Blood loss – Most frequently menstruation in older girls

• Sickle cell, Thalassaemia, Leukaemia

Investigations

• Bloods - FBC (Hb, MCV), Reticulocyte, Ferritin, B12, Folate, Bilirubin

• Blood film

• Direct Coombs test