Hemoglobin life-threatening value (1.9\u2009g/dl) in good general condition: a pediatric case-report

Emilia Parodi,Lorenzo Riboldi,Ugo Ramenghi

doi:10.1186/s13052-021-01146-w

Abstract

BackgroundWe report a pediatric patient presenting in good general condition despite a hemoglobin value of 1,9 g/dL, which is normally regarded as life-threatening.Case presentationAn African 5 years-old girl presented to our Emergency Department (ED) for worsening asthenia, within a clinical picture of good general condition. The hemoglobin value at admission was 1,9 g/dL. The subsequent diagnostic-therapeutic pathway highlighted the presence of two different causes, both well known to be responsible for chronic anemia (with slow reduction of hemoglobin values): iron deficiency anemia (IDA) due to a very low dietary intake of iron-rich foods, and homozygous sickle cell disease (HbSS). She received transfusions of packed red blood cells (overall 15 ml/kg) and subsequently intravenous iron preparations (total amount 200 mg) followed by oral iron supplements. The Hb value at discharge, 10 days after the admission, was 9.8 g/dL.ConclusionsWhen approaching a picture of severe anemia, we suggest pediatricians take into consideration clinical conditions rather than laboratory values and to take advantage of detailed anamnestic data in order to make the diagnosis.

Highlights

Anemia is a serious global public health problem that affects young children; the World Health Organization (WHO) estimates that worldwide, 42% of children less than 5 years of age are anemic
When approaching a picture of severe anemia, we suggest pediatricians take into consideration clinical conditions rather than laboratory values and to take advantage of detailed anamnestic data in order to make the diagnosis
According to the WHO, severe anemia is defined with the cut-off of 7 g/dL in children < 5 years and 8 g/dL in children > 5 years; in the clinical practice, the definition of severity of anemia is mainly based on clinical presentation

Summary

Conclusions

When approaching a picture of severe anemia, we suggest pediatricians take into consideration clinical conditions rather than laboratory values and to take advantage of detailed anamnestic data in order to make the diagnosis.

Introduction

Findings

Discussion and conclusions