Microcytic Anaemia

Clinical Description

Anaemia Hb less than 9g/dl and mean Corpuscular Volume (MCV) less than 70.

• Causes: Iron deficiency anaemia, Thalassemia, Lead poisoning, Copper deficiency, Sideroblastic anaemia

Children

• Young children (less than 6 years) are anemic if their Hb is less than 9 g/dl. Begin treatment unless the child has severe malnutrition, in which case, refer to nutrition chapter.
• Give treatment with iron for 14 days
• Review the child in in 14 days.
• Continue treatment for 3 months.
• If the child is ≥1 year and has not received Mebendazole in the previous 6 months, give one dose of Mebendazole 500mg alternatively

Albendazole (200mg or 400mg depending on age)

• Advise the mother about good feeding practice

Pregnancy

• Refer to Reproductive Health (Chapter 12)

Adults

• If Hb less than 7 g/dl
• If Hb less than 8 g/dl and there are clinical complications

Dose

• One unit of whole blood or one unit of red cell suspension will raise a patient's hemoglobin by 1-1.5g/dl

Pre-operative Surgery

• If Hb less than 8 g/dl

Red Flags

• If suboptimal rise or fall in hemoglobin level after transfusion and there are signs of haemolysis (such as jaundice, raised bilirubin level, lactate dehydrogenase), refer the patient for specialist management.

Vitamin B12 deficiency

• Transfusion should be avoided unless the patient has symptomatic anaemia and even then, the minimum possible amount of blood or red cell suspension should be transfused e.g., one pediatric unit for an adult patient.