"Iron deficiency anemia (IDA) is the most common anemia among the age groups of children prone to this disease. However, it most commonly occurs in 0-5 years old infants," said Prof. Dr. dr. Djajadiman Gatot, Sp.A (K), the Division of Hematology and Oncology, Department of Pediatric FKUI/RSCM, and the Chairperson of IDAI Task Force.
IDA is commonly caused by several factors, such as malnutrition, improper food absorption, quick growth of infants and teenagers, intestinal worms, chronic infection, and diseases that damage the red blood cells. The exposure to excessive pollution also has negative impact on the iron level in the blood.
Do not underestimate
Generally the people suffering from anemia show several signs through their body, such as fatigue, weakness, pale face, fast heartbeat, and shortness of breath. In some cases, hair loss also occurs. However, the sufferers might also indicate no specific symptoms. When occurring for a long time, even with a low level of hemoglobin, this disease might exhibit no certain symptoms because the body has adapted to it.
Anemia is not a sudden disease. There are three stages in the formation of this disease. The first is the iron depletion, the first step towards iron deficiency. This is when the iron store starts to decrease, while the iron level in the blood plasma is still normal, so are the hemoglobin and hematocrit levels.
The next stage is the iron deficiency without anemia. At this stage, the iron store and the iron in the blood plasma start to decrease, while the hemoglobin remains normal. In the final stage, the iron deficiency anemia has occurred, the iron in the blood plasma and the hemoglobin level are all lowered. " That' s why, hemoglobin examination alone is not enough to figure out whether a child is having IDA or not. One more thing to examine is the ferritin serum, which indicates the total amount of the iron store," Prof. Djajadiman asserted.
As explained by Prof. Djajadiman, anemia is not something to belittle. When it occurs for more than two years, children will have their intelligence decreased, their IQ is down. "Do not expect their IQ to go beyond 100. 90s is the highest they can reach. In the morning they learn a subject, in the evening they will completely forget about it. It is because the iron deficiency also disrupts the formation of neurotransmitter substance, which is important in controlling emotion and concentrating in the context of their behavior," Prof. Djajadiman asserted.
Iron deficiency delays the brain cell (dendrite) branching in children, resulting in lower complexity of the brain and slower information processing and also impedes the myelination, leading to visual, auditory, and behavioral disorders. This condition also causes metabolic disorder in the central controllers of their emotion and cognition.
In addition, iron deficiency also lowers the activities of tryptophan and tyrosine hydroxylase enzymes, causing disruption in the production of serotonin and dopamine. As a result, children are unable to control themselves and their feeling, unable to concentrate or keep up well with the lesson, and disturbed by behavioral disorder.
Anemia will be dangerous once it gets complicated by other diseases. Therefore, it is crucial to have laboratory examination, particularly a complete blood test. Beware that, after the cause and symptom are detected and the diagnosis is established, the occurring anemia might lead to thalassemia.
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