In this section
Anaemia is defined as Hb less than the lower limit of the
reference range for age:
If anaemia is suspected begin with a full blood examination,
blood film and reticulocyte count.
Any further investigations will be determined by the blood film
The initial classification is based on the MCV:
Usually requires admission and repeat FBE within 6-12 hours to
detect continuing haemolysis. Acute haemolysis in childhood can be
a life threatening illness.
Investigations: blood film for RBC
abnormalities (eg. spherocytosis), Coomb's test, G6PD screen,
Note: HbA2 may not be elevated in the presence
of concomitant iron deficiency, therefore give iron therapy
(if ferritin low) before ordering test.
Rare causes of Microcytic Anaemia
(eg. acute leukaemia, aplastic anaemia, infiltrative
Rare in children; discuss with registrar or consultant.
If associated with Failure to thrive or neurodevelopmental
problems then must be investigated and treated urgently.