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AnemiaSupervisor: dr. Pertin Sianturi, M.Ked(Ped), Sp.A(K)
Presentator: Boris (110100076)
Try udia !amad"any (11010011#)
$AS% !%P&!T
Department of Pediatric Health
Faculty of Medicine Universitas Sumatera Utara
H. Adam Malik General Hospital
Medan 2!"
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#iterature $evie%
&hat is anemia'''
Anemia is a reduction in red cell mass or
H( and is usually defined as H( or Hct) 2standard deviations (elo% the mean for
a*e.
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Physiolo*ic AnemiaPhysiolo*ic anemia is the most common cause of anemia
in the neonatal period. +ormal physiolo*ic processes oftencause normocytic,normochromic anemia in term and preterm
infants. Physiolo*ic anemia do not *enerally re-uire etensive
evaluation or treatment.
/n term infants0 the increase in oy*enation that occurs%ith normal (reathin* after (irth causes an a(rupt rise in
tissue 1 2 level0 resultin* in ne*ative feed(ack on
erythropoietin production and erythropoiesis. his reduction in
erythropoietin0 as %ell as the shorter life span of neonatal
$34s 56 days vs !2 days in adults70 causes H(concentration to fall over the first 2 to 8 mo of life 5typical H(
nadir 6 to !! *9d#7. H( remains sta(le over the net several
%eeks and then slo%ly rises in the :th to ;th mo secondary to
rene%ed erythropoietin stimulation.
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Dia*nose
History
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Mana*ement
1(servation and Supportive 4are1(servation and Supportive 4are
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4ase $eport
&'etive: he o(=ective of this paper is to report acase of 8,month old *irl %ith a dia*nosis of Anemia.
*ame : S>PA+e:8 months old
Se:Female
-ate o Admission: 1cto(er ?th2!"
$"ie omp/aint: Prematurity
istory o disease:S>P %as reffered from @ina Hospital to Adam Malik General Hospitalto receive ade-uate treatment. 4hief complaint %as prematurity andS>P %as admitted to the perinatolo*y department.
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istory o mediation: unclear
istory o ami/y: unclear
istory o parents mediation:Antihypertensive a*entsprescri(ed (y o(stetrician
istory o pre+nany: he mother %as 8 years old %henpre*nant 5G2P2A7. S>P %as (orn %ith =ust 8 %eeks ofpre*nancy. History of hypertension in pre*nancy %asfound and %as treated %ith anti,hypertensive a*ents
prescri(ed (y o(stetrician. History of dia(etes inpre*nancy %as dinied.
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istory o 'irt": S>P %as (orn in @ina Hospital %ith only8 %eeks of pre*nancy and %as helped (y o(stetricianvia 4aesarean method. 3& %hen (orn is !*. 3# isunclear.
istory o eedin+: 3reastfeeded for2 months.istory o immuni2ation: unclear
istory o +ro3t" and deve/opment: unclear
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Physical
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hora B Symmetrical fusiform0 4hest retraction 5,7.
H$B !:(pm0 re*ular0 murmur 5,7$$B :9i0 re*ular0 ronchi 5,9,70 vesicular %ith no
additional sound.
A(domen B Soft0 non tender0 normal peristaltic0 liver
and spleen %ere not palpa(le0 Ascites 5,70 umor 5,7.
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#a(oratory Findin*sTest !esu/t 8nit !eerene
H( #.90 * !.?,!?.!$34 .07 !;9mm8 8.?",:.6"
#eucocyte 6.6; !89mm8 ;.,!?."
hrom(ocyte :"! !89mm8 2!?,:6?
Ht 97.60 8,"2
M4@ 6.6 f# 68,!!"
M4H 2;.? p* 26,8"
M4H4 26.? f# 2,8:
$D& 2." !:.6,!.?
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Follo% Up&to'er 7t"=#t"901>
S 4ryin* is loud0 suckin* is stron*.& Semsorium: 4M0 empB 8?.o40 reflees are *ood.
ead:
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P Place in incu(ator %ith temperature ran*e 8;.",8?."o4Fluid demand !?cc93&9day ParenteralB none
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A Unproven sepsisAnemia ec, 4hronic Disease
, A31 /ncompati(ility , 1$4H , G;PD Defficiency , 3acterial /nfection
Prematurity
P Place in incu(ator %ith temperature ran*e 8;.",8?."o4Fluid demand !?cc93&9day ParenteralB none
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&to'er 10t"=11t"901>
S 4ryin* is loud0 suckin* is stron*
& Sensorium: 4M0 empB 8?.!o40 reflees are *ood.ead:
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P Place in incu(ator %ith temperature ran*e 8;.",8?."o4Fluid demand !?cc93&9day ParenteralB none
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& Sensorium: 4M0 empB 8?.!o40 reflees are *ood.ead:
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P Place in incu(ator %ith temperature ran*e 8;.",8?."o4Fluid demand !?cc93&9day ParenteralB none
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A Unproven sepsis/UG$ 5/ntraUterine Gro%th $etardation7Anemia ec, 4hronic Disease
, A31 /ncompati(ility , 1$4H , G;PD Defficiency , 3acterial /nfectionPrematurity
P Place in incu(ator %ith temperature ran*e 8;.",8?."o4
Fluid demand 2cc93&9day ParenteralB none
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& Sensorium: 4M0 empB 8?.!o40 reflees are *ood.ead:
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Discussion
T"eory $ase
Anemia has many causes0one of those are caused (ydecreased $34 production.
his may (e caused (ychronic disease0 irondefficiency0 poor diet0infection and also (yprematurity.
/n this case0 S>P %as (ornpreamature/yat the*estational a*e of 0 3ees
and %as present %ithrespiratory distress.
Dia*nosin* anemia can (eperformed (y history takin*0physical eamination0 and
also other dia*nostic tests.
/n this case0 dia*nosis ofanemia is done (yperformin* dia*nostic tests
such as omp/ete '/oodount.
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T"eory $ase
Mana*ement of anemiais done (y o(servational
and supportive care0medication and also irontherapy if needed.
1(servational andsupportive care %as
done (y placin* thepatient in an inu'ator%ith contolledtemperature0 eedin+
the patient %ith milk andkeepin* the /uid in'a/aneand also (y*ivin* iron.
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Summary
S>P0 8 months old %as admitted to H. AdamMalik General Hospital (ecause of prematurityand %as later dia*nosed %ith C Anemia ecchronic disease C /UG$ C Prematurity and %astreated %ith supportive care (y providin*incu(ator and feedin* and also (y *ivin* oraliron therapy and multivitamin
Apialys !.8cc
Ferri !.8cc
@itamin < !2"/U
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