Unrecognized severe anemia in children presenting with respiratory distress

The cases of four children who presented with respiratory distress unresponsive to bronchodilator treatment and who were subsequently diagnosed with severe anemia were retrospectively reviewed from charts at a children's hospital with 110 beds and an emergency department census of 32,000 per ye...

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Bibliographic Details
Published in:The American journal of emergency medicine 1998-07, Vol.16 (4), p.386-389
Main Authors: Hetzel, Thomas M, Losek, Joseph D
Format: Article
Language:English
Subjects:
Anemia
Anemia, Aplastic - blood
Anemia, Aplastic - complications
Anemia, Aplastic - therapy
Anemia, Iron-Deficiency - blood
Anemia, Iron-Deficiency - complications
Anemia, Iron-Deficiency - therapy
Anemias. Hemoglobinopathies
Biological and medical sciences
Blood Transfusion
Child, Preschool
Diagnosis, Differential
Diseases of red blood cells
Dyspnea - etiology
Female
Hematologic and hematopoietic diseases
Hemoglobins - analysis
Humans
Infant
Male
Medical sciences
pallor
Precursor Cell Lymphoblastic Leukemia-Lymphoma - blood
Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
respiratory distress
Respiratory Sounds - etiology
Retrospective Studies
tachypnea
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Summary:The cases of four children who presented with respiratory distress unresponsive to bronchodilator treatment and who were subsequently diagnosed with severe anemia were retrospectively reviewed from charts at a children's hospital with 110 beds and an emergency department census of 32,000 per year. The four children, age range 11 months to 2 years, each initially presented with tachypnea. Three had wheezing, three were pale, and each received outpatient bronchodilator treatment. Three to 4 days later, each patient was hospitalized for continued respiratory distress. Each child was pale, and hemoglobin levels ranged from 2.5 to 5.2 g/dL. In three children, respiratory distress resolved with blood transfusions. Final diagnoses were transient erythroblastopenia of childhood in 2, acute lymphoblastic leukemia in 1, and iron deficiency anemia in 1. Severe anemia is a known cause of respiratory distress. These cases remind the clinician to consider severe anemia in children who are tachypneic, pale, and unresponsive to treatment of respiratory disorders.
ISSN:0735-6757
1532-8171
DOI:10.1016/S0735-6757(98)90135-8