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Pediatric Acute Anemia Differential Diagnoses

  • Author: Susumu Inoue, MD; Chief Editor: Robert J Arceci, MD, PhD  more...
 
Updated: Oct 09, 2015
 
 

Diagnostic Considerations

Conditions to consider, aside from those in the next section, in the differential diagnosis of acute anemia include the following:

  • Acute hemorrhage
  • Anemia of inflammation/infection
  • Aplastic anemia, due to blood loss
  • Autoimmune hemolytic anemia with acute hemolysis
  • Erythrophagocytosis (hemophagocytic lymphohistiocytosis [HLH])
  • G-6-PD deficiency, hemolytic episode
  • Hereditary spherocytosis, splenic sequestration, or acute hemolytic episode
  • Microangiopathic hemolytic anemia (DIC, Kasabach-Merritt phenomenon)
  • Paroxysmal cold hemoglobinuria
  • Paroxysmal nocturnal hemoglobinuria (PNH)
  • Hemolytic disease of newborn
  • Hemolytic-uremic syndrome
  • Acute porphyria

Conditions to consider, aside from those in the next section, in the differential diagnosis of chronic anemia include the following:

  • Chronic renal failure
  • Congenital dyserythropoietic anemia
  • Fanconi anemia
  • Iron deficiency anemia
  • Diamond-Blackfan anemia
  • Osteopetrosis
  • Sideroblastic anemia
  • Unstable hemoglobinopathy
  • Thymoma
  • Transient erythroblastopenia of childhood
  • Pyruvate kinase deficiency
  • Evans syndrome (ITP and autoimmune hemolytic anemia)
  • Hemoglobin H disease
  • Hypothyroidism
  • Myelofibrosis
  • Aplastic or hypoplastic anemia
  • Autoimmune hemolytic anemia
  • Pure red cell aplasia
  • PNH

Many anemias may be due to a combination of several mechanisms. For example, anemia due to acute infection is due to temporal suppression of erythropoiesis and some degree of hemolysis.

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Susumu Inoue, MD Professor of Pediatrics and Human Development, Michigan State University College of Human Medicine; Clinical Professor of Pediatrics, Wayne State University School of Medicine; Director of Pediatric Hematology/Oncology, Associate Director of Pediatric Education, Department of Pediatrics, Hurley Medical Center

Susumu Inoue, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Clinical Oncology, American Society of Hematology, American Society of Pediatric Hematology/Oncology, Society for Pediatric Research

Disclosure: Nothing to disclose.

Coauthor(s)

Margaret T Lee, MD Associate Professor, Department of Pediatrics, Division of Pediatric Hematology/Oncology/SCT, Children's Hospital of New York, Columbia University College of Physicians and Surgeons

Margaret T Lee, MD is a member of the following medical societies: American Society of Hematology

Disclosure: Nothing to disclose.

Chief Editor

Robert J Arceci, MD, PhD Director, Children’s Center for Cancer and Blood Disorders, Department of Hematology/Oncology, Co-Director of the Ron Matricaria Institute of Molecular Medicine, Phoenix Children’s Hospital; Editor-in-Chief, Pediatric Blood and Cancer; Professor, Department of Child Health, University of Arizona College of Medicine

Robert J Arceci, MD, PhD is a member of the following medical societies: American Association for the Advancement of Science, American Association for Cancer Research, American Pediatric Society, American Society of Hematology, American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

Acknowledgements

Steven K Bergstrom, MD Department of Pediatrics, Division of Hematology-Oncology, Kaiser Permanente Medical Center of Oakland

Steven K Bergstrom, MD is a member of the following medical societies: Alpha Omega Alpha, American Society of Clinical Oncology, American Society of Hematology, American Society of Pediatric Hematology/Oncology, Children's Oncology Group, and International Society for Experimental Hematology

Disclosure: Nothing to disclose.

J Martin Johnston, MD Associate Professor of Pediatrics, Mercer University School of Medicine; Director of Pediatric Hematology/Oncology, Backus Children's Hospital; Consulting Oncologist/Hematologist, St Damien's Pediatric Hospital

J Martin Johnston, MD is a member of the following medical societies: American Academy of Pediatrics and American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

John T Truman, MD, MPH Professor Emeritus of Clinical Pediatrics, Columbia University College of Physicians and Surgeons

John T Truman, MD, MPH is a member of the following medical societies: American Academy of Pediatrics, American Association for the History of Medicine, American Society of Pediatric Nephrology, and New York Academy of Medicine

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References
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Algorithm for diagnostic approach and workup of anemia in children. Hb=hemoglobin; Hct=hematocrit; HS=hereditary spherocytosis; HE=hereditary elliptocytosis; G-6-PD=glucose-6-phosphate dehydrogenase; PK=pyruvate kinase; HUS=hemolytic uremic syndrome; TTP=thrombotic thrombocytopenic purpura; DIC=disseminated intravascular coagulation; DBA=Diamond-Blackfan anemia.
 
 
 
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