Haematological Profile in the Differential Diagnosis of Microcytic Hypochromic Anaemia in Children.

Anaemia, Whether Clinically Overt Or Not Is A Common Condition Encountered By The Family Physician. The Most Commonly Encountered Disorders Manifesting With Mild Microcytic Hypochromic Anaemia Are Iron Deficiency Anemia (IDA) And Thalassemia Trait (TT)1,2. Hypochromic Microcytic Aneamia Could Also Be Due To Anaemia Of Chronic Disease Or Lead Poisoning. The Establishment Of An Accurate Diagnosis Is Of Great Importance In Ensuring Correct Treatment. Administration Of Iron To A Patient With Hypochromic Aneamia Due To A Cause Other Than Iron Deficiency Is Not Only Useless But Also Leads To Undesirable Effects Of Increase In Body Iron Stores. Thalassemia Minor And Thalassemia Intermedia May Pass Off As Iron Deficiency Anaemia, If Only Peripheral Smear Was The Sole Diagnostic Modality. Β-Thalassemia Is Also An Iron Loading Anemia, Meaning That Thalassemic Patients Have A Dramatic Increase In Iron Absorption From The Gut Due To Their Increased Erythropoietic Rate3–6. Together With The Iron Influx From Chronic Transfusions The Setting Of Iron Overload Is Observed In Thalassemic Patients. Inadvertent Iron Therapy Will Prove Detrimental In Such Situations. Iron Plays An Essential Role In Many Important Biochemical Processes 7. As With All Nutrients, The Requirement For Iron Is Greater During Periods Of Rapid Growth And Differentiation Such As In The Late Fetal And Neonatal Period. Consequently, Poor Iron Homeostasis During This Period Can Result In Disordered Development. Inadequate Tissue Iron Levels Can Lead To Reduced Erythropoiesis And Poor O2-Carrying Capacity. The Nervous System, Which Develops Rapidly During The Late Fetal And Early Neonatal Period, Seems To Be Particularly Susceptible To Iron Deficiency And Excess 8. Also, Iron Excess Can Have Severe Effects On Neuron Development 6–8. Thus, Events Occurring In Early Life Can Have Long-Lasting Effects On Neuronal Function In The Adult. Excessive Iron In The Circulation Leads To Abnormal Accumulation In Organs Such As Liver, Spleen And Heart, Leading Ultimately To Liver Disease, Cardiac Dysfunction, Arthropathy, Gonadal Insufficiency And Other Endocrine Disorders (Hoffman Et Al., Hematology, Basic Principles And Practice15). Twenty Percent Of Children In US And Eighty Percent Of Children In Developing Countries Are Anaemic At Some Point Of Time By The Age Of 18 Years (American Fam Physician 2001:64:1364-79). Hence It Is Worthwhile To Study The Hematological Profile Including Serum Iron, Serum Iron Binding Capacity, Haemoglobin Electrophoresis And Bone Marrow Iron Which Would Delineate These Disease Entities And Enable Correct Management. Timely Management Of Anaemia In Growing Buds Is Very Important Especially For A Developing Country Like India As The Children Of Today Are The Best National Resource Of Tomorrow