[Incidence and aetiology of anaemia in hospitalized children in Costa Rica (author's transl)].
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Biomedical subjects
Publications and source records attributed to L A Mora.
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Thirty-five spinal fluids with leucocytosis belonging to 26 children presenting neoplasia without metastases or CNS infection, were studied. We found that 69% of the cases were receiving some kind of CNS therapy, although leucocytosis could be found at any moment of the evolution and independently of treatment. It is stressed that the criteria for meningeal infiltration in children with neoplasia must be established only if tumoral cells are found in the spinal fluid. Pleocytosis and absence of symptomatology must not be used as the main criteria.
The study included 30 children with anemia and significant infectious process. The hematologic characteristics of this anemia were identified in their evolution and these findings were correlated with levels of serum iron to disclose whether variations are present to support the diagnosis of mixed etiology of the anemic syndrome. Transferrin saturation index was found to be the best parameter to diagnose iron deficiency in cases of anemia associated to infectious processes and due to the fact that 50% of these cases showed mixed etiology anemia, it seems reasonable that further integral studies should be carried out in this anemic syndrome.
The laboratory tests used to establish the diagnosis of infection in the newborn period were studied and it was found that more than 700 band cells/mm3 in peripheral blood supported the diagnosis of sepsis and that concomitant thrombocytopenia increased these possibilities. Among the other tests, only the IgM was found of diagnostic value in cases of intrauterine infection.
In eighty nine anemic children, aged from 6 months to 13 years, the etiology of their anemia was studied: 67(75%) of the cases presented iron deficiency, 18(20%) iron and folate deficiency and 4 megaloblastic anemia (2 folate and 2 vitamin B12 deficiency). Patients with vitamin B12 deficiency showed severe pancytopenia and megaloblastic changes in bone marrow; but no morphological difference, either in circulating blood or bone marrow was found in patients with iron deficiency, compared to iron plus folate deficiency. The seric measurement of iron, folate and B12 were essential in order to establish the etiology of nutritional anemias. The majority of the children were accepted to the hospital for other causes than anemia, such as diarrhea (58%) and respiratory diseases (18%). Clinical features and the high incidence of anemia in children under two years of age are also discussed.