A two-and-a-half-year-old breastfed toddler presenting with anemia: a case report

BMC Research Notes

Berend Isermann¹  Ronald Biemann¹  Peter Vorwerk²  Katrin Borucki¹  Fabian Bock³ 

[1] Department of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany;Department of Pediatrics, Otto-von-Guericke-University, Leipziger Straße 44, 39120 Magdeburg, Germany;Department of Internal Medicine I and Clinical Chemistry, University of Heidelberg, INF 410, 69120 Heidelberg, Germany

关键词: Iron deficiency;    Breastfeeding;    Anemia;   

Others  :  1091851
DOI  :  10.1186/1756-0500-7-917

 received in 2014-08-08, accepted in 2014-12-06,  发布年份 2014

【 摘 要 】

Background

Anemia is a common presentation in children but the differential diagnosis of iron deficiency and β-thalassemia remains a diagnostic challenge. Red blood cell indices have been shown to perform weakly in such scenarios. One potential cause is breastfeeding, but the evidence for unusually prolonged exclusive breastfeeding as a cause of iron deficiency anemia in older (>2 years) toddlers is sparse and the association of breastfeeding with iron deficiency in this age group of older toddlers is not unequivocally established. In this case we describe an unusual cause of nutritional iron deficiency anemia in the age group of 2–3 years.

Case presentation

We describe a two-and-a-half-year-old Turkish boy who presented to our outpatient clinic with recurrent diarrhea and anemia. The patient was febrile (99.1°F) with pale skin and signs of mild dehydration. A reduced nutritional status with a weight of 11.5 kg between the 3rd and 10th percentile was noted. Nutritional evaluation revealed that the boy was still exclusively breastfed with more than 6 times breastfeedings per day. Iron supplementation ameliorated the anemia and reduced hypochromic red blood cells.

Conclusion

The case demonstrates that unusually prolonged (longer than two years) exclusive breastfeeding is a potential cause of iron deficiency anemia in older toddlers. We discuss a simple combination of laboratory tests with ferritin and red cell distribution width that together with a nutritional evaluation provide a quick diagnosis and show that even at such an advanced stage of nutritional iron deficiency oral iron supplementation is an effective treatment.

【 授权许可】

   
2014 Bock et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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