Retrospective evaluation of deep anemia cases hospitalized in Dicle Universitymedical Faculty Child Hospital between 2012-2017 in our clinic

Objectıve: Profound anemia is one of the major health problems and it is common in both developed and developing countries. The purpose of this study is to determine the demographic, clinical and laboratory characteristics of patients who were admitted to our hospital due to profound anemia and to determine the etiology of the diseases causing profound anemia. Materıals and Methods: A total of 437 patients with profound anemia who were hospitalized between the dates of 2012 and 2017 in the Dicle University Medical Faculty Children's Hospital were retrospectively studied. Age, gender, complaints, physical examination and laboratory findings were evaluated to investigate the causes of the diseases that causing profound anemia. Profound anemia criteria defined by the World Health Organization was accepted as cutoff values. Results: 237 of the 437 patients with profound anemia were male (54.2 %) and 200 were female (45.8 %). Majority of patients were male. The mean age was 52 months (1–210) and 243 patients (55.6 %) were between 1 and 24 months. Patients often had nonspecific symptoms such as paleness, fever, anorexia, and fatigue. The most common vital finding at the time of admission was tachycardia. Mean hemoglobin value was 5,55 ± 1,1 g/dL and mean hematocrit value was 19.06 ± 4,6 %. Bicytopenia was present in 16.7 % of patients and pancytopenia was in 4.3 % of patients. 60.3 % of patients with bicytopenia had anemia and thrombocytopenia together. Acute leukemia was detected in 32 (60 %) of 53 (12.1 %) patients who underwent to bone marrow aspiration. Seventy-five percent of patients who were diagnosed with acute leukemia had bicytopenia. The patients were diagnosed with anemia of iron deficiency (47.6 %), megaloblastic anemia (14 %), β thalassemia (10 %), iron deficiency anemia + megaloblastic anemia (8.9 %), acute leukemia (7.3 %), hereditary spherocytosis (3.4 %), sickle cell anemia (3.2 %), autoimmune hemolytic anemia (1.6 %), aplastic anemia (1.6 %), anemia secondary to infection (1.1 %), dyserethropoietic anemia (0.7 %), transient erythroblastopenia in childhood and anemia due to glucose 6 phosphate dehydrogenase enzyme deficiency (0.2 %) respectively. The most frequent anemia was iron deficiency anemia (47.6 %). 49.5 % of patients with iron deficiency anemia were between 1 and 24 months of age. There was statistically significant difference of Hct, MCV, MCHC, RDW, serum iron level, ferritin level and total iron binding capacity (p <0.05) between the patients with and without iron deficiency anemia. Conclusıon: Worldwide studies show that nutritional deficiencies constitute a significant part of the profound anemia. When we examined the causes of profound anemia in our study, it was observed that the most common etiologic causes were anemia of iron deficiency and megaloblastic anemia. The increase in iron intake and animal food consumption are thought to reduce the frequency of profound anemia in our country and worldwide. In patients presenting with anemia, other cell series can be also detected low. In cases where other cell lines are affected, acute leukemia, aplastic anemia, the diseases should be excluded. Keywords: Severe anemia, child, iron deficiency anemia, etiological causes.