Evaluation of children followed up for nutritional anemia in our hospital

Background: Anemia is an important problem of public health that is widespread throughout the world. Anemia occurs in all age groups, including childhood. Although there are many different causes of anemia, nutritional causes are the most common. Our purpose in this study is to examine the types, clinical features, laboratory findings, and characteristics that influence nutritional anemia in patients aged 6 months to 18 years in our city. Materials and Methods: Cases diagnosed with nutritional anemia in the pediatric outpatient clinics of our hospital in the three-year period between 2019 and 2021 were included in this study. Results: In our study, 2030 (48.1%) of the patients were male and 2187 (51.9%) of the patients were female. Of these cases, 1268 (30.1%) were between 6 and 24 months, 856 (20.3%) between 25 and 60 months, 718 (17%) between 61 and 144 months, and 1375 (32.6%) older than 144 months. According to the MCV, 3110 (73.7%) were assessed as microcytic anemia, 781 (18.5%) as megaloblastic anemia and 326 (7.7%) as mixed-type anemia. Compared to the boys, the girls had a higher TDBK value and a lower transferrin saturation (368.6±57.5 vs. 361.7±56.9 µg/dl, p=0.028 ve 19.9±11.3 ve 20.1±11.4, p=0.02, respectively). Serum 25 (OH) vitamin D levels belong to the megaloblastic and mixed anemia groups were significantly lower than those in the microcytic anemia group (14.2±9.3 vs. 15.8±9.9 ng/ml, p<0.001 and 12.8±8.9 vs. 15.8±9.9 ng/ml, p<0.001, respectively). 216 of our cases (6.9%) with microcytic anemia had malnutrition and 174 of them (5.5%) had obesity, 90 of our cases (11.5%) with megaloblastic anemia had malnutrition and 42 of them (5.4%) had obesity, and 24 of our cases (7.4%) with mixed type anemia had malnutrition and 15 of them (4.6%) had obesity. The incidence of malnutrition was significantly higher in those with megaloblastic anemia than in those with microcytic anemia (p=0.033). Conclusions: Nutritional anemias frequently occur in childhood and adolescence. These anemias can be diagnosed by appropriate laboratory tests. Among the types of nutritional anemias, microcytic anemias are the most common. As mixed forms of these anaemias can also occur, caution is required in the diagnosis phase. Microcytic anemias are particularly common in girls. In these cases, a coexistence of nutritional anemia and malnutrition can be observed. Since lower than normal levels of serum 25 (OH) vitamin D may be a risk factor for the development of nutritional anemias, this should also be taken into account during the treatment phase. Key Words: Nutritional anemia, child, microcytic anemia, megaloblastic anemia, mixed type anemia, vitamin D