Anämiediagnostik im Kindesalter

Zusammenfassung

Die Differenzialdiagnose der Anämie im Kindes- und Jugendalter fußt auf dem Blutbild unter Berücksichtigung der Erythrozyten-indices und der Retikulozytenzahl. Neben Anamnese und körperlicher Untersuchung können gezielte, über das Blutbild hinausgehende Laboruntersuchungen Hinweise zur Differenzialdiagnose liefern. Die Leitlinie schlägt Algorithmen für ein systematisches Vorgehen in der Anämiediagnostik vor.

Summary

The differential diagnosis of childhood anaemia is based on a complete blood count with regard to the erythrocyte indices and the reticulocyte count. Besides history and physical examination, more specialized laboratory examinations can lead to a definite diagnosis. This guideline offers algorithms for a systematic differential diagnosis of anaemia.

Schlüsselwörter

Anämie - Hämoglobin - MCV - Retikulozyten

Keywords

Anaemia - haemoglobin - MCV - reticulocytes

• Literatur

• 1 Aladjidi et al for the Centre de Référence National des Cytopénies Auto-immunes de l’Enfant (CEREVANCE). New insights into childhood autoimmune hemolytic anemia: a French national observational study of 265 children. Haematologica 2011; 96: 655-663.
• 2 Behnisch W, Muckenthaler M, Kulozik A. AWMFLeitlinie Eisenmangelanämie 025/021 (2010)
• 3 Ball SE, McGuckin CP, Jenkins G, Gordon-Smith EC. Diamond-Blackfan anaemia in the U.K.: analysis of 80 cases from a 20 year birth cohort. Br J Haematol 1996; 94: 645-653.
• 4 Bianchi P, Fermo E, Vercellati C C. et al Diagnostic power of laboratory tests for hereditary spherocytosis: a comparison study on 150 patients grouped according to the molecular and clinical characteristics. Haematologica 2012; 97 (12) e47
• 5 Cappellini MD, Fiorelli G. Glucose-6-phosphate dehydrogenase deficiency. Lancet 2008; 371: 64-74.
• 6 Centers for Disease Control and Prevention Iron deficiency: United States, 1999–2000. MMWR. Morb Mortal Wkly Rep 2002; 51: 897-899.
• 7 Coppo P, Veyradier A. Thrombotic microangiopathies: towards a pathophysiology-based classification. Cardiovascular & Haematological Disorders- Drug Targets 2009; 9: 36-50.
• 8 Dickerhoff R. AWMF-Leitlinie Sichelzellkrankheit 025/016 (2010)
• 9 Dixon NE, Crissman BG, Smith PB. et al. Prevalence of iron deficiency in children with Down syndrome. J Pediatrics 2010; 157: 967-971.
• 10 Finberg KE, Heeney MW, Campagna DR. et al. Mutations in TMPRSS6 cause iron-refractory iron deficiency anemia (IRIDA). Nat Genet 2008; 40: 569-571.
• 11 Jain S, Narayab S, Chandra J. et al. Evaluation of serum transferring receptor and sTfR ferritin indices in diagnosing and differentiating iron deficiency anemia from anemia of chronic disease. Indian J Pediatr 2010; 77: 179-183.
• 12 Hollowell JG, van Assendelft OW, Gunter EW. et al. Hematological and ironrelated analytes – Reference data for persons aged 1 year and over: United States, 1988–94. National Center for Health Statistics. Vital Health Stat 2005. 11 (247)
• 13 Kulozik A. Thalassämien. In: Gadner, Gaedicke, Niemeyer, Ritter (Hrsg.) Pädiatrische Hämatologie und Onkologie Heidelberg: Springer; 2006
• 14 Saarinen UM, Siimes MA. Developmental changes in red blood cell counts and indices of infants after exclusion of iron deficiency by laboratory criteria and continuous iron supplementation. J Pediatr 1978; 92: 412-416.
• 15 Skeppner G, Wranne L. Transient erythroblastopenia of childhood in Sweden: incidence and findings at the time of diagnosis. Acta Paediatr 1993; 82: 574-578.
• 16 Takala TI, Mäkelä E, Suominen P. et al. Blood cell and iron status analytes of preterm and fullterm infants from 20 weeks onwards during the first year of life. Clin Chem Lab Med 2010; 48: 1295-1301.
• 17 Tarallo P, Humbert J-C, Mahassen P. et at. Reticulocytes: Biological variations and reference limits. Eur J Haematol 1994; 53: 11-15.
• 18 White KC. Anemia is a poor predictor of iron deficiency among toddlers in the United States: For Heme the Bell tolls. Pediatrics 200 115: 315-320.