Iron Deficiency Anemia (IDA)
IDA is the most common nutritional deficiency in children, typically occurring due to increased demand during rapid growth periods or inadequate dietary intake.
1. Pathophysiology & Etiology
| Age Group | Primary Cause |
|---|---|
| Infants (6–24 mo) | Dietary deficiency (e.g., exclusive breastfeeding beyond 6 mo, excessive cow’s milk). |
| Older Children | Increased growth needs or occult blood loss (e.g., parasitic infection). |
2. Clinical & Laboratory Findings
- Symptoms: Pallor (most common), irritability, fatigue, pica (eating non-food items), and in severe cases, cognitive impairment.
- Peripheral Smear: Microcytic, hypochromic anemia with anisocytosis and poikilocytosis.
- Iron Profile: Low Serum Iron, Low Ferritin (most sensitive), High Total Iron Binding Capacity (TIBC).
3. Management Principles
- Therapy: Oral elemental iron (3–6 mg/kg/day).
- Counseling: Limit cow’s milk intake to < 500 ml/day (excessive milk blocks iron absorption and may cause occult intestinal blood loss).
- Response: Reticulocytosis occurs within 3–5 days; hemoglobin levels should rise significantly after 2–4 weeks.
NEET PG Hint: Ferritin is the most sensitive diagnostic marker for IDA, but remember it is also an acute-phase reactant and may be falsely normal/high in the presence of inflammation or infection. Always check the peripheral smear for microcytosis as the hallmark finding.