The following is a summary of “Etiologies and Outcomes of Normocytic Anemia in Children,” published in the March 2024 issue of Pediatrics by Equitz et al.

This retrospective cohort study aimed to characterize the evaluation and outcomes of pediatric patients comprehensively referred to a tertiary pediatric hematology clinic for normocytic anemia between 2019 and 2021.

The study included 271 pediatric patients aged 0 to 21. Normocytic anemia was defined based on laboratory reference ranges, specifically as a low hemoglobin level accompanied by a normal mean corpuscular volume.

The cohort consisted of 48% female patients, with a median age of 5.4 years. The most prevalent hematologic diagnoses among these patients included iron deficiency (33%), statistical anemia (24%), transient marrow suppression (13%), and transient erythroblastopenia of childhood (7%). A small subset (6%) of patients had anemia attributed to non-hematologic disorders and were referred to other pediatric specialties. Sixteen patients (6%) experienced spontaneous resolution of anemia without a discernible underlying cause. Besides those with iron deficiency, 13% of patients had diagnoses necessitating ongoing hematology care, such as transient erythroblastopenia of childhood, hemolytic anemia, Diamond Blackfan Anemia, and abnormal beta globin traits. Most (93%) of patients were discharged from hematology care after a median follow-up period of 25 days, ranging from 0 to 2124 days.

Pediatric patients presenting with normocytic anemia exhibit a diverse range of underlying etiologies, with iron deficiency being the most prevalent. These findings underscore the importance of initial evaluation and management within primary care settings, including assessing serum ferritin, iron panel, and reticulocyte count. Only a subset of patients necessitate ongoing subspecialty hematology care, highlighting the need for individualized management approaches tailored to each patient’s specific needs.

Source: sciencedirect.com/science/article/abs/pii/S0022347624001446