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Severe forms of anemia in children in the developing countries may be characterized by different clinical manifestations at particular stages of development. Whether this reflects developmental changes in adaptation to anemia or other mechanisms is not clear. The pattern of adaptation to anemia has been assessed in 110 individuals with hemoglobin (Hb) E beta-thalassemia, one of the commonest forms of inherited anemia in Asia. It has been found that age and Hb levels are independent variables with respect to erythropoietin response and that there is a decline in the latter at a similar degree of anemia during development. To determine whether this finding is applicable to anemia due to other causes, a similar study has been carried out on 279 children with severe anemia due to Plasmodium falciparum malaria; the results were similar to those in the patients with thalassemia. These observations may have important implications both for the better understanding of the pathophysiology of profound anemia in early life and for its more logical and cost-effective management.

Original publication

DOI

10.1073/pnas.0703424104

Type

Journal article

Journal

Proc Natl Acad Sci U S A

Publication Date

29/05/2007

Volume

104

Pages

9440 - 9444

Keywords

Adaptation, Physiological, Adolescent, Adult, Age Distribution, Aging, Anemia, Animals, Child, Child, Preschool, Developing Countries, Erythropoietin, Humans, Infant, Malaria, Falciparum, Middle Aged, beta-Thalassemia