RT Book, Section
A1 Heeney, Matthew M.
A2 Rudolph, Colin D.
A2 Rudolph, Abraham M.
A2 Lister, George E.
A2 First, Lewis R.
A2 Gershon, Anne A.
SR Print(0)
ID 7039423
T1 Chapter 430. Anemia
T2 Rudolph's Pediatrics, 22e
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-149723-7
LK accesspediatrics.mhmedical.com/content.aspx?aid=7039423
RD 2024/04/19
AB Anemia  is  defined  as  lower  than  normal  values  of  hemoglobin,  or  hematocrit.  The  lower  limit  of  the  normal  range  is  set  arbitrarily  at  2  standard  deviations  below  the  mean  for  any  given  age  and  gender.1  The  observed  age  and  gender-related  differences  in  the  “normal”  hemoglobin  level  during  the  first  decade  of  life  and  after  puberty  (see  Fig.  429-4)  must  be  considered  in  making  a  diagnosis  of  anemia.2  Some  laboratories  use  only  adult  normal  range  values  and  will  erroneously  report  normal  pediatric  levels  of  hemoglobin  as  low.  Defining  anemia  as  a  hemoglobin  measurement  2  standard  deviations  below  the  mean  results  in  2.5%  of  normal  children  being  classified  as  being  anemic.  Such  individuals  may  track  at  their  own  low  level  over  extended  periods  of  time  but  are  identified  by  ruling  out  other  treatable  causes.  Conversely,  some  individuals  have  hemoglobin  values  in  the  lower  part  of  the  normal  range  that  may  increase  after  treatment  with  iron  or  after  the  resolution  of  an  infectious  or  inflammatory  process.  Age-related  normal  means  and  lower  limits  of  normal  hemoglobin,  hematocrit,  and  mean  corpuscular  volume  (MCV)  are  shown  in  Table  429-1.  Figure  429-4  depicts  the  pattern  of  normal  mean  hemoglobin  levels  from  birth  to  adult  life.