Unusual symptoms of iron deficiency anemia (2 clinical observations)

Iron deficiency is a leading cause of anemia, the most common malnutrition worldwide, affecting 42% of children worldwide. Most often, iron deficiency occurs in children of the first year of life and adolescents; its prevalence in adolescents has pronounced gender differences. In Russia, it is much more common in girls — in 17.2–31.0% of cases, which is 1.6 times higher than in boys. The presence of delayed adverse effects of iron deficiency at an early age has been established, therefore, timely correction of sideropenic conditions in young children is important for the prevention of long-term consequences of a child’s development. The article presents two clinical cases of iron deficiency anemia in adolescent girls who had iron deficiency in the first year of life. On the example of the first clinical observation, we observe the development of alopecia against the background of severe sideropenia as part of the epithelial syndrome with iron deficiency anemia of moderate severity. Iron deficiency in this case is multifactorial — maternal anemia during pregnancy, spontaneous subarachnoid hemorrhage, shunt infection, and uncorrected iron deficiency in the first two years. The second clinical example illustrates iron deficiency anemia of mixed genesis in a teenage girl, which was the result of insufficient iron stores at birth, alimentary insufficiency, aggravated against the background of heavy, prolonged menstruation. In this case, there is no hair loss, despite the more severe course of anemia, a long refractory period with iron therapy. The data of clinical cases confirm the significance of low iron stores at birth in the risk of developing iron deficiency anemia in puberty. During the examination of children, the need to take into account the state of the gastrointestinal tract in the algorithm for diagnosing the state of the gastrointestinal tract (detection of malabsorption, blood loss) was shown.