Nayana N. S1, Sreenivas N2, Shubha Jayaram3

INTRODUCTION AND OBJECTIVES: Anemia in Protein energy malnutrition (PEM) is common and its pathogenesis is multifactorial. Since the clinico-pathological patterns are reflected by their underlying etiopathogenic factors, it is important to study the associated morbidity and mortality and to establish their causes for an effective management. The purpose of the present study is to determine the prevalence, patterns, clinico-pathological and morphological types of anemia in protein energy malnutrition children. The objectives of the study are: (1) To study the clinico-pathological and morphological patterns of anemia in PEM children of age group 6 month – 5 years. (2) To assess the resultant morbidity and mortality. (3) To determine the ideal parameter for iron deficiency anemia.

METHODS: This study was conducted on 75 clinically diagnosed Protein energy malnutrition patients of age group 6 months to 5 years. Detailed clinical history elicitation and thorough clinical examination was performed. Peripheral smears of these patients were examined. The complete hemogram including reticulocyte count was done. The special investigations like bone marrow study, Hb electrophoresis, iron studies and stool examination were done whenever required.

RESULTS: In our study, anemia in PEM affected female population more than the males of age 36-47 months. Most of children had Grade III PEM and Microcytic hypochromic anemia was most prevalent. Most of the children had Iron deficiency anemia. This study also indicated that Serum iron assay and TIBC are the better indicators of iron deficiency anemia in patients with PEM and it is the investigation of choice when compared to serum ferritin as it gets falsely elevated in these patients with infections confirmed by elevated CRP level.

INTERPRETATION AND CONCLUSION: Malnutrition, Infection and Anemia show a synergistic relationship. So it necessitates prompt screening and early diagnosis through proper investigation, by utilization of available advanced technical modalities in order to initiate timely treatment and appropriate management.