Anemia
Specialized Care for a Common Yet Complex Condition
Children with anemia do not have enough red blood cells in the body. Since red blood cells contain hemoglobin — the iron-containing protein complex in the blood which carries oxygen — having anemia also results in low hemoglobin levels. Because tissues and organs in the body may not receive enough oxygen, people with anemia may feel tired.
There are many types and causes of anemia. It takes expert knowledge and experience to correctly identify the cause of anemia in an individual patient and choose the most effective treatment. The pediatric hematologists at NewYork-Presbyterian Komansky Children's Hospital and NewYork-Presbyterian Morgan Stanley Children's Hospital provide onsite screening, diagnostic and genetic testing, treatment, counseling, education, and support for children with anemia and their families. Our goal is to help your child live the healthiest and most active life possible.
Types of anemia
Some types of anemia may be inherited and life-long, but most are acquired and temporary. Based on their cause, anemias can be divided into three main groups:
- Anemia caused by blood loss. Acute bleeding after an injury trauma, chronic bleeding from the digestive or genitourinary tract, or excessive menstruation can lower red blood cell counts.
- Anemia caused by problems with red blood cell production. Not getting enough nutrients (such as iron, folate, and vitamin B12), an inherited blood disorder called thalassemia, and conditions resulting in bone marrow failure (such as Fanconi anemia or Diamond-Blackfan anemia) can result in the body not making enough red blood cells or making faulty red blood cells.
- Anemia caused by the destruction of red blood cells. Examples include sickle cell anemia, hereditary spherocytosis, G6PD deficiency, and autoimmune hemolytic anemia.
Signs and symptoms of anemia
Anemia may be present without causing any symptoms and be detected on a routine blood test. When symptoms do arise, they may include:
- Fatigue (feeling tired)
- Looking pale
- Faster heart rate
- Shortness of breath
- Dizziness/lightheadedness
- Headache
- Irritability
How we diagnose anemia
The diagnosis of anemia begins with routine blood testing including a complete blood count (CBC) and a "reticulocyte" count. The reticulocyte count shows the percentage of young red blood cells in the bloodstream. This count is typically high when there is blood loss or when anemia is caused by increased destruction of the red blood cells, but low when there is faulty red blood cell production in the bone marrow. An experienced hematologist will also look at the appearance of red blood cells under the microscope to be able to determine the type of anemia. If the disorder stems from problems in the bone marrow, in rare cases we may take a bone marrow sample for analysis.
The information we learn from these tests is very important because it helps us decide the best treatment to use for your child. If the anemia is inherited, we may conduct genetic testing and also offer genetic testing and counseling to other interested family members.
Our Approach to Care
Our care teams include pediatric hematologists with years of experience treating many types of anemia, as well as nurses and nurse practitioners, physical therapists, registered dietitians, social workers, genetic counselors, and special laboratory personnel who perform the needed blood tests. If your child has a lifelong type of anemia, we provide transitional care as they approach young adulthood to encourage them to become independent advocates of their health.
Anemia treatment
Your child's care is personalized based on the type and cause of anemia. Treatments may include:
- Nutritional supplements with vitamins and/or iron
- Dietary changes, guided by the expertise of a registered dietitian
- Stopping any medicines that may be causing anemia
- Treating an underlying disorder that is causing anemia, such as thalassemia or sickle cell disease
- Erythropoietin to stimulate red blood cell production, given by injection or intravenously (by vein), for some children with anemia due to chronic kidney disease or cancer chemotherapy
- Blood transfusions when needed to treat significant red blood cell loss, offered in the comfort of our dedicated pediatric infusion centers
- Surgery to remove the spleen (a treatment for some hemolytic anemias)
- Stem cell transplantation to replace the blood-forming system in children with serious inherited disorders such as sickle cell disease, thalassemia, Fanconi anemia, Diamond-Blackfan anemia, or aplastic anemia
Why Choose Us
When anemia is temporary, we work to help your child regain healthy red blood cells and return to feeling better. If the anemia is long-term, your child will need the kind of lifetime care that we provide at NewYork-Presbyterian's children's hospitals. Our teams have experience with every treatment for anemia and its complications, along with support and education to help your child and family learn to live with the disorder. Weill Cornell Medicine and Columbia University investigators also conduct clinical trials of promising new treatments for blood disorders, such as gene therapy for sickle cell disease. We will let you know if your child is able to participate in one of these studies. Call us today to find out how we can help you and to make an appointment.