Common Blood Disorders in Children : Types, Causes, Symptoms & Treatments

Blood is the crucial body fluid that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. It is made of various components, each of which has a different role.

The four major components of blood include:

• Red blood cells- Transfers oxygen and energy to various cells of the body, and takes waste away from them
• White blood cells- Fights against infections and provide immunity
• Platelets- Prevents bleeding by helping in blood clotting
• Plasma (in which all the above are suspended) – Has various roles like maintaining blood pressure, carrying electrolytes and hormones, maintaining pH balance, etc.

Blood disorders involve the imbalance or pathology of one or more components of the blood. Since the components of blood play a crucial role in everyday health, these disorders can lead to a variety of symptoms affecting health significantly. Children are growing beings and any of these disorders can significantly affect their growth and development as well. Children can be either born with blood disorders or acquire them later in life, in either case, early detection leads to early treatment and better chances of recovery.

What are the symptoms of blood disorders?

Symptoms of blood disorders will depend on the type of disorder. Broadly if a child has any of the below a blood disorder should be suspected:

-Fast heart rate

-Frequent infections leading to repeated hospitalisations

-Excess bleeding and easy bruisability

-Slow healing of wounds

-Tiredness

-Low energy in children

Some other serious symptoms can include seizures, pain crisis and stroke where the child loses consciousness.

Common Blood Disorders in Children : Types, Causes, Symptoms & Treatments

What causes blood disorders?

Blood disorders could be present by birth, or can be acquired later in life. When acquired they could be due to infections, nutritional deficiency, autoimmune or cancerous causes. Detailed investigation and diagnosis by a specialist pediatric haematologist and oncologist can help in finding the underlying cause and treatment of blood disorders in children.

Common blood disorders

Though there can be many blood disorders in children, below listed are some common disorders. These are listed as per the blood component affected.

Blood disorders of the Red Blood Cells

• Anemia

The most common blood disorder of the red blood cell is Anemia. It occurs when there is a decrease in the number of red blood cells or hemoglobin, leading to reduced oxygen flow to the body’s organs.

What causes Anemia?

• Nutritional deficiency anemia

This is a common type of anemia in children, primarily caused by a lack of essential nutrients that are crucial for red blood cell production. The most common form is iron deficiency anemia, but deficiencies in vitamins, vitamin B12, and folate can also lead to anemia.

Symptoms

Some symptoms of nutritional deficiency anemia include:

-Fatigue

-Pale skin

-Irritability

-Breathlessness

-Pica- Craving for non-food items like dirt, mud, chalk

-Vitamin B12 deficiency can also lead toa tingling sensation in nerves (pins and needles sensation)

Nutritional deficiency anemia doesn’t always result due to less intake of essential nutrients. At times, there may be an underlying disease that could cause malabsorption of the nutrients leading to anemias. Example, celiac disease, and inflammatory bowel disease. Thus, a detailed checkup with a doctor is essential to identify and treat the condition.

• Sickle cell anemia

Few  genetic mutations in children can  result in abnormally shaped

 red blood cells. The red blood cells here are shaped like a sickle or crescent. These

misshapen cells can block normal blood flow and also break down prematurely,

leading to chronic anemia.

Symptoms of sickle cell anemia

• Painful episodes of crisis due to blockage of blood flow
• Fatigue and irritability
• Swelling in hand and feet
• Symptoms of anemia as breathlessness, low energy
• Delayed growth and development

This anemia is diagnosed during newborn screening in most cases. Since this is a genetic condition, it may require frequent blood transfusions and bone marrow transplants in severe cases.

Thalassemia

This is also a genetic condition, that affects the production of haemoglobin. It can vary in severity depending on the type and gene affected. The haemoglobin has four globulin chains, the alpha and beta and either can be affected in this condition depending on the genetic mutation.

Types

Thalassemia can be alpha or beta thalassemia, the former affects the alpha-chain globulin and the latter affects beta-chain globulin.

Symptoms

Thalassemia can vary significantly in presentation. In some cases when the condition is minor the child may lead a normal life with just some changes in the blood picture. However, in thalassemia major the child needs frequent blood transfusions for survival. Some symptoms include:

-Mild to severe anemia

-Fatigue and weakness

-Bone deformities (in severe cases)

-Delayed growth and development

-Jaundice

Disorders of the White blood cells    

• Leukemia

Leukemia is the most common cancer in children. It affects the blood and bone marrow, leading to the production of abnormal white blood cells.

The mature white blood cells or their precursors are affected and produced abnormally, this also leads to the suppression of other blood cells including red blood cells and platelets. Depending on the series of cells affected it can be of  different types.

The common leukemias in children include:

• Acute lymphoblastic leukemia (ALL):

This cancer is characterized by the overproduction of immature white blood cells, called lymphoblasts in the bone marrow. Early diagnosis is critical in improving health outcomes in children who suffer from ALL.

Symptoms of ALL

Common  symptoms include:

–Fatigue and Weakness: Caused by anemia due to the lack of healthy red blood cells.

-Frequent Infections: Due to a deficiency in normal, functioning white blood cells.

-Fever

-Easy Bruising and Bleeding: Low platelet counts can lead to frequent nosebleeds, gum bleeding, and easy bruising.

-Bone and Joint Pain: Leukemic cells can accumulate in the bone marrow, causing pain.

-Swollen Lymph Nodes: Accumulation of cells in lymph nodes can lead to enlarged lymph nodes, particularly in the neck, underarm, or groin.

-Abdominal Pain: Due to an enlarged liver or spleen which can occur due to infiltration of cells

-Pale Skin: Due to anemia caused by suppressed red blood cells

-Loss of Appetite and Weight Loss

Most cases of ALL occur in children aged 2-5 years.

• Acute Myeloid Leukemia

Acute myeloid leukemia (AML) is also a type of cancer that originates in the bone marrow. The lineage of cells affected by AML are known as myeloblasts. Although less common than acute lymphoblastic leukemia (ALL), AML accounts for about 15-20% of childhood leukemias. Early diagnosis and treatment are crucial for improving outcomes.

Features similar tothose in ALL are seen in this condition too.

Disorders of Platelets and Plasma

• Hemophilia

Hemophilia is a genetic disorder that impairs the blood’s ability to clot, leading to excessive bleeding. Normally there are various clotting factors present in the plasma that come together to form the blood clot. This prevents internal and external bleeding by  sealing of capillaries and blood vessels at the time of major and minor injuries.

In Hemophilia, essential  clotting factors VIII or IX is absent.

Haemophilia A is when factor VIII is deficient or absent, and Hemophilia B is the deficiency of factor IX.

Symptoms

 Easy bruising, spontaneous bleeding, prolonged bleeding after injuries or surgeries, and joint pain.

This is a serious condition and needs early diagnosis and management. Children with Haemophilia require frequent factor therapies ..

• Immune Thrombocytopenic Purpura

This is an autoimmune condition where the immune cells of the body attack platelets. This leads to low platelets and thus increased risk of bleeding.

Symptoms: of ITP include easy bruising, petechiae, echymotic patches, nose bleeds, gum bleeds, etc.

Disorder affecting all blood cells

• Aplastic Anemia

Aplastic anemia is a rare but serious blood disorder that occurs when the bone marrow fails to produce enough blood cells. This condition can lead to a deficiency in red blood cells, white blood cells, and platelets, causing various health problems, including fatigue, frequent infections, and easy bleeding. Although aplastic anemia can affect people of any age, it can be particularly challenging in children due to its impact on their growth and development. Early diagnosis and treatment are crucial for managing the condition and improving outcomes.

This can be a genetic and acquired condition and requires extensive management.

Health conditions though come uninformed; each child should be given the best possible chance to fight with them. A pediatric haematologist and oncologist understands the specific needs of little children and help them tackle these plethoras of blood conditions in children with the best possible support and empathy.