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Toddlers with anasarca and severe anemia: a lesson in preventive medicine

Salstrom, Jennifer L.a; Kent, Michaela; Liang, Xiayuanb; Wang, Michaela

doi: 10.1097/MOP.0b013e32834dfc92

Two toddlers presented to their primary medical providers with anasarca and severe anemia. Laboratory evaluation revealed iron deficiency along with hypoproteinemia and hypoalbuminemia. Both children were diagnosed with iron deficiency anemia and were suspected to have an associated protein-losing enteropathy. A brief review of the literature is provided, and data supporting the notion of protein-losing enteropathy being a consequence of severe iron deficiency anemia are discussed. The American Academy of Pediatrics recommendations for prevention of iron deficiency anemia are reviewed. These cases illustrate the importance of the primary medical care provider's role in preventive medicine and provide an example of severe complications that may arise from iron deficiency anemia if it is not recognized and treated early.

aDepartment of Pediatric Hematology, Oncology, and Bone Marrow Transplantation, Rick Wilson Center for Cancer and Blood Disorders

bDepartment of Pathology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.

Correspondence to Michael Wang, MD, Hemophilia and Thrombosis Center, University of Colorado School of Medicine, 13199 East Montview Boulevard, Suite 100, Aurora, CO 80045, USA. Tel: +1 303 724 0724; fax: +1 303 724 0947; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.