Clinical, Hematological, and Etiological Profile of Anemia in Children and Adolescents: An Observational Study

Abstract

Background: Pediatric anemia is a heterogeneous clinical problem in which nutritional deficiency, chronic inflammation, hemoglobinopathy, hemolysis, and marrow failure may produce overlapping symptoms but distinct hematological signatures.

Aim: To describe the clinical presentation, hematological indices, morphological patterns, etiological spectrum, and severity distribution of anemia among children and adolescents evaluated in a pediatric department.

Materials and Methods: This observational study included 70 children and adolescents enrolled between May 2025 and April 2026. Age, sex, presenting symptoms, complete blood count indices, iron profile, transferrin saturation, peripheral smear findings, anemia morphology, etiology, and severity category were analysed. Categorical variables were summarised as frequencies and percentages. Continuous variables were expressed as mean ± standard deviation. Chi-square test and Kruskal-Wallis test were used where appropriate, with p<0.05 considered statistically significant.

Results: The mean age was 7.28 ± 4.57 years, and the sex distribution was equal, with 35 males and 35 females. Mean hemoglobin was 8.23 ± 1.61 g/dL. Moderate anemia was the commonest severity category, observed in 39 children (55.7%), followed by mild anemia in 18 (25.7%) and severe anemia in 13 (18.6%). Normocytic anemia was the most frequent morphology (36/70, 51.4%), followed by microcytic anemia (30/70, 42.9%). Iron deficiency anemia was the leading etiology (20/70, 28.6%), followed by sickle cell disease/variants (13/70, 18.6%), anemia of chronic disease (12/70, 17.1%), and thalassemia minor (10/70, 14.3%). Morphology was significantly associated with severity (chi-square=21.13, p<0.001).

Conclusion: The study shows that pediatric anemia is not a single nutritional entity. Although iron deficiency remained the largest etiological group, normocytic anemia related to chronic disease and hemolytic disorders formed a substantial proportion. A combined clinical, CBC, iron profile, and smear-based approach is therefore essential for accurate pediatric anemia evaluation.