TY - CHAP M1 - Book, Section TI - Chapter 430. Anemia A1 - Heeney, Matthew M. A2 - Rudolph, Colin D. A2 - Rudolph, Abraham M. A2 - Lister, George E. A2 - First, Lewis R. A2 - Gershon, Anne A. Y1 - 2011 N1 - T2 - Rudolph's Pediatrics, 22e 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. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=7039423 ER -