TY - CHAP M1 - Book, Section TI - Anemia Due to Diminished Red Blood Cell Production A1 - Narla, Anupama A2 - Kline, Mark W. Y1 - 2018 N1 - T2 - Rudolph's Pediatrics, 23e AB - The production of mature red blood cells (RBCs) from hematopoietic stem cells is a tightly regulated process that is dependent on growth factors, specific niches, and physiologic needs. Erythropoiesis normally proceeds at a basal rate, allowing for the replacement of senescent RBCs, which constitute 1% of red cell mass, with young reticulocytes produced within the bone marrow. However, red cell production can be enhanced by as much as 10- to 20-fold in a variety of clinical settings in which there is decreased arterial blood oxygenation and/or oxygen delivery to the tissues. In the absence of critical components required for erythropoiesis, the bone marrow is unable to produce an adequate number of red cells, ultimately leading to anemia. Anemia may be the first hematologic finding in a child with abnormal bone marrow function; it may be the sole problem (single cytopenia) or occur in conjunction with deficits in other cell lineages (pancytopenia). The cause may be a deficiency of a required nutrient (eg, iron, folic acid, vitamin B12), the inability of the marrow to use nutrients because of concomitant medical conditions (eg, inflammation, hypothyroidism), or intrinsic bone marrow failure. Bone marrow failure may be either inherited or acquired (aplastic anemia). This chapter will highlight the causes of anemia that are due to diminished RBC production. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1182909751 ER -