All issues > Volume 46(9); 2003

Original Article

J Korean Pediatr Soc. 2003;46(9):883-888. Published online September 15, 2003.

A Clinical Study on Childhood Hemolytic Anemia According to Etiological Classification

Hae-Sik HS Kwon¹, Jung-Chul JC Kang¹, Sung-Chul SC Won¹, Seung-Hwan SH Oh¹, Chuhl-Joo CJ Lyu¹

¹Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea

Correspondence Chuhl-Joo CJ Lyu ,Email: cj@yumc.yonsei.ac.kr

Abstract

Purpose
: The etiology of hemolytic anemia can be classified as either cellular or extracellular defects of red blood cells. The aim of this study was to investigate the clinical and laboratory findings of hemolytic anemia concerning its etiological classification.
Methods
: Clinical and laboratory findings of the patients with hemolytic anemia treated from January 1987 to May 2002 at Severance Hospital were analyzed retrospectively. They were divided into two groups based on the types of red cell defects(group I : erythrocytic defect, group II : extraerythrocytic defect).
Results
: Twenty one cases were included in group I, thirty four cases in group II, and three cases were unclassified. In group I, nineteen cases(90.5%) were diagnosed as hereditary spherocytosis and were proved to have red cell membrane disorders while two cases(9.5%) were shown to have red cell enzyme deficiencies. In group II, thirteen cases(38.2%) were noted as autoimmune hemolytic anemia, eleven cases(32.4%) as traumatic or microangiopathic hemolytic anemia, four cases(11.8%) as drug induced hemolytic anemia, two cases(5.9%) were related with systemic lupus erythematosus and one case(2.9%) with malignancy. Hemoglobin at the time of diagnosis(7.5 g/dL vs. 6.2 g/dL, P< 0.05) and the incidence of splenomegaly(85.7% vs. 18.2%, P<0.05) were higher in group I though blood urea nitrogen(9.0/0.4 mg/dL vs. 27.8/1.6 mg/dL, P<0.05) was higher in group II.
Conclusion
: Comparing the clinical features of pediatric hemolytic anemia, we concluded as following : In cases associated with extraerythrocytic defect, blood tests revealed significant initial lower hematocrit with higher level of BUN and Cr while cases with erythrocytic defect, splenomegaly were more common noted.

Keywords :Hemolytic anemia, Intrinsic red cell defects, Extrinsic red cell defects, Etiological classification