RT Book, Section
A1 Narla, Anupama
A2 Kline, Mark W.
SR Print(0)
ID 1154139887
T1 Anemia Due to Diminished Red Blood Cell Production
T2 Rudolph's Pediatrics, 23e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259588594
LK accesspediatrics.mhmedical.com/content.aspx?aid=1154139887
RD 2021/04/10
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.