Chapter 10. Diseases of the Blood and Hematopoietic Organs
19 topics with concise summaries: definitions, key facts, and class questions.
Pediatric hematology is not simply a "minified copy" of adult hematology. In this section, we will analyze how blood parameters change as a child grows and learn to interpret the complete blood count (CBC) to confidently distinguish pathology from physiological norms.
The chapter covers three extensive blocks. The first focuses on deficiency states: we will analyze iron deficiency anemia in detail (from diagnosis to prevention) and the specifics of anemia of prematurity. The second block is dedicated to hemostasis disorders: you will learn how to perform differential diagnosis between immune thrombocytopenia, thrombocytopathies, von Willebrand disease, and hemophilia. The third covers oncohematology: clinical presentation, diagnosis, and treatment of acute leukemias, as well as Hodgkin lymphoma.
Practical classes and exams most frequently test algorithms for the differential diagnosis of hemorrhagic syndromes and the calculation of iron supplement dosages in iron deficiency anemia. Study these topics with particular care—they will be useful not just for getting a good grade, but also in the daily practice of a pediatrician.
Why does a 2-month-old infant have a hemoglobin level of 95 g/L, and the physician does not diagnose anemia?
By 2 months of age, hemoglobin levels reach their "physiological nadir." At this age, the lower limit of normal is 90 g/L, so a value of 95 g/L is considered normal.
What is the main laboratory criterion for diagnosing anemia?
The primary criterion is a decrease in hemoglobin (Hb) concentration per unit volume of blood. Severity assessment is also based exclusively on this parameter.
How does latent iron deficiency differ from IDA?
In latent iron deficiency, only tissue reserves are depleted (ferritin levels drop), but hemoglobin and erythrocyte counts in the complete blood count remain within normal limits. IDA manifests only after the body's iron stores are completely exhausted.
Can iron deficiency anemia be cured solely with a diet rich in meat and apples?
No. It is impossible to replenish an already developed iron deficiency solely through diet. The mandatory prescription of medications is required.
What criteria confirm that iron supplementation therapy is working?
Efficacy is confirmed by a reticulocyte crisis in 7–10 days and an increase in hemoglobin by at least 10 g/L after 4 weeks.
Why is iron from vegetables and fruits insufficient for a child?
Plant-based foods contain non-heme iron, the bioavailability of which is extremely low—the body absorbs only about 5% of this micronutrient from them.
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