746 Consequences of delayed presentation of iron deficiency anaemia during the COVID pandemic

BackgroundAnaemia affects roughly a third of the world’s population; half the cases are due to iron deficiency. It is a major and global public health problem that affects child morbidity and mortality. Children aged 0–5 years are particularly at risk.Treatment strategies include prevention, through...

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Bibliographic Details
Published in:Archives of disease in childhood 2021-10, Vol.106 (Suppl 1), p.A101-A101
Main Authors: Osama, DIAB, Gandecha, Hema, Rizvi, Gulmeena, Sundaram, Prem, Umezurike, Indira
Format: Article
Language:English
Subjects:
Abstracts
anaemia
Anemia
Blood transfusion
complications
Dietary supplements
Emergency medical care
Emergency medical services
Fatigue
Fatigue (Biology)
Females
Ferritin
Folic acid
Health care
Hematocrit
Hemoglobin
Iron
Iron deficiency
Malignancy
Medical Services
Morbidity
Nutrient deficiency
pandemic
Pandemics
Parents
Pediatrics
Public health
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Summary:BackgroundAnaemia affects roughly a third of the world’s population; half the cases are due to iron deficiency. It is a major and global public health problem that affects child morbidity and mortality. Children aged 0–5 years are particularly at risk.Treatment strategies include prevention, through food fortification and iron supplementation, and early detection.ObjectivesWe present two cases with an insidious presentation and complications of iron deficiency anaemia. We highlight a need to do more to educate parents and carers on the importance of not delaying in seeking medical care, during the current pandemic, as in both cases parents did not feel safe to contact services sooner.MethodsTwo cases aged 14- and 29-months-old Asian (Indian) girls who presented to the Emergency Department, with sever pallor, tiredness and lack of activity/energy. History revealed that both had been pale for several months; however, parents were hesitant to seek medical advice because of the fear of exposure to corona virus infection.Full blood count (FBC) showed haemoglobin levels of 16 and 29 g/l respectively.Other causes like haemoglobinopathy, malignancy and infection were excluded, and the diagnosis of Iron deficiency anaemia was confirmed.They both had received blood transfusion which was easily avoidable. Fortunately, they were not showing any signs of high output cardiac failure and after four days they were discharged home safely.ResultsResults Case 1 Case 2 Age 29 months 14 months Sex female female Ethnicity Asian Asian Weight (centile) 11 kg (9th-25th percentile) 9.6 kg (50th percentile) Symptoms Pallor, fatigue and hypoactivity Pallor, fatigue and hypoactivity Haemoglobin (gram/l) 25 15 Haematocrit 0.122 0.065 MCV 49 49 Red cell count (*1012/L) 2.21 1.34 White cell count 11 9.7 Platelet count 843 214 Reticulocyte count 30 29 Ferritin (microgram/l) < 2 < 2 VitaminB12 (nanogram/L) 947 912 Folate (microgram/L) 15.9 14.8 Chest X-ray cardiomegaly cardiomegaly Echo cardiogram normal normal Coeliac antibody negative negative Haemoglobin A2 1.4% 1.3% Haemoglobin F 0.9% 1.1% ConclusionsDelayed presentation of easily preventable health issues is clearly still a problem, during the current pandemic, despite efforts made by health organisations. The message needs to be reiterated and further steps need to be taken towards health education and public orientation through different multimedia messaging to encourage people to seek medical advice early when needed. due to the lo
ISSN:0003-9888
1468-2044
DOI:10.1136/archdischild-2021-rcpch.176