Table Of ContentAnemia in the Young
aaaannnndddd OOOOlllldddd
Diagnosis and Management
Robert T. Means Jr.
Editor
123
Anemia in the Young and Old
Robert T. Means Jr.
Editor
Anemia in the Young
and Old
Diagnosis and Management
Editor
Robert T. Means Jr.
James H. Quillen College of Medicine
East Tennessee State University
James H. Quillen College of Medicine
Johnson City, TN
USA
ISBN 978-3-319-96486-7 ISBN 978-3-319-96487-4 (eBook)
https://doi.org/10.1007/978-3-319-96487-4
Library of Congress Control Number: 2018959025
© Springer Nature Switzerland AG 2019
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims
in published maps and institutional affiliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
To my wife,
Stacey W. McKenzie, MD:
my colleague in the most important things.
Preface
The genesis of this book derives from a session presented as part of the educational
program at the American Society of Hematology meeting in 2016. Entitled “Anemia
in the Young and Old,” the session was organized by Dr. David Steensma and con-
sisted of a talk by Dr. Steensma on clonal hematopoiesis of indeterminate potential
(CHIP), a talk by Dr. Michael Auerbach on the use of intravenous iron therapy, and
a talk by me on pure red cell aplasia (PRCA). It was a very well received session.
However, the focus of the session was certainly on adult medicine with a slant
toward older patients. CHIP is a syndrome primarily observed in the elderly; while
iron deficiency certainly occurs in children, the focus of the talk on that topic was
largely on adults; and for my part, I mentioned Diamond Blackfan Anemia and
transient erythroblastopenia of childhood solely to say that I was not going to talk
about them any further in my presentation. However, sometime after that I was con-
tacted by the publishers of this book and asked if I would consider editing a book
with the title “Anemia in the Young and Old.” While the topics of CHIP and iron
deficiency in adults as well as PRCA are certainly covered, the primary resemblance
to the education program session is the title. In preparing this book, the aim was to
include authors whose expertise either was in anemic disorders of adults or of chil-
dren, and the goal of the chapters was to help the readers appreciate the nuances of
anemia diagnosis and management in these different populations. For example, iron
deficiency is a major contributor to anemia in both children and in the elderly.
However, iron deficiency in children has a tendency to be more nutritional in its
basis, and iron deficiency in the elderly tends to result primarily from blood loss,
usually from some acquired anatomic defect. While it has been proposed that the
normal hemoglobin range for the elderly be set lower than the usual World Health
Organization (WHO) adult range of >13.0 g/dL for men and 12.0 g/dL for women
(as discussed in the chapter on approaches to anemia in the elderly), the WHO nor-
mal range for children actually is lower than that (as discussed in the chapter on
approaches to anemia in childhood).
vii
viii Preface
I wish to thank Andy Kwan and Dhanapal Palanisamy at Springer for their sup-
port of this project, and, of course, the contributors. As always, my primary thanks
goes to my wife Stacey and our three children, Casey, Robert, and Patrick, for their
support and forbearance in this as in all of my other activities.
Johnson City, TN, USA Robert T. Means Jr.
June 2018
Contents
Part I Approaches
1 Introduction: Anemia at the Extremes of Life . . . . . . . . . . . . . . . . . . . 3
Robert T. Means Jr.
2 Diagnostic Approach to Anemia in Childhood
and Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Jenny K. McDaniel and Caryn E. Sorge
3 Approach to Anemia in the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Robert T. Means Jr.
Part II Specific Disorders
4 Inherited Bone Marrow Failure Syndromes . . . . . . . . . . . . . . . . . . . . 39
Jennifer D. Hamm and Caryn E. Sorge
5 Iron-Deficiency Anemia During Childhood . . . . . . . . . . . . . . . . . . . . . 81
Yara Perez, Kendall Presti, Alvin N. Eden,
and Claudio Sandoval
6 Anemia at the Extremes of Life: Congenital
Hemolytic Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Ariel L. Reinish and Suzie A. Noronha
7 Immune-Mediated Hemolytic Anemia . . . . . . . . . . . . . . . . . . . . . . . . . 137
Ilene Weitz
8 Anemia of Renal Failure/Chronic Kidney Disease . . . . . . . . . . . . . . . 147
Robert T. Means Jr.
9 The Anemia of Inflammation/Chronic Disease
and the Unexplained Anemia of the Elderly . . . . . . . . . . . . . . . . . . . . . 157
Robert T. Means Jr.
ix
x Contents
10 Pure Red Cell Aplasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Robert T. Means Jr.
11 Anemia in Elderly Patients: State of Art, with a Focus
on Nutritional Anemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Emmanuel Andrès, Thomas Vogel, and Abrar Zulfiqar
12 Clonal Hematopoiesis and Cytopenias in the Elderly . . . . . . . . . . . . . 195
Daniel Guy, Amber Afzal, and Meagan A. Jacoby
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Contributors
Amber Afzal Division of Oncology, Department of Internal Medicine, Washington
University School of Medicine, St. Louis, MO, USA
Emmanuel Andrès Department of Internal Medicine, Diabetes and Metabolic
Disorders, University Hospital of Strasbourg, Strasbourg, France
Alvin N. Eden, MD Department of Pediatrics, New York Medical College,
Valhalla, NY, USA
Daniel Guy Division of Oncology, Department of Internal Medicine, Washington
University School of Medicine, St. Louis, MO, USA
Jennifer D. Hamm, MD Department of Pediatrics, Division of Pediatric
Hematology/Oncology, East Tennessee Children’s Hospital, Knoxville, TN, USA
Meagan A. Jacoby Division of Oncology, Department of Internal Medicine,
Washington University School of Medicine, St. Louis, MO, USA
Jenny K. McDaniel, MD Department of Pediatrics, Division of Pediatric
Hematology/Oncology, St. Jude Affiliate Clinic at Novant Health Hemby Children’s
Hospital, Charlotte, NC, USA
Robert T. Means Jr., MD James H. Quillen College of Medicine, East Tennessee
State University, Johnson City, TN, USA
Suzie A. Noronha, MD Division of Pediatric Hematology/Oncology, Golisano
Children’s Hospital, University of Rochester Medical Center, Rochester, NY, USA
Yara Perez, MD Department of Pediatrics, New York Medical College, Valhalla,
NY, USA
Kendall Presti, BS Department of Pediatrics, New York Medical College, Valhalla,
NY, USA
Ariel L. Reinish, MD Division of Pediatric Hematology/Oncology, Golisano
Children’s Hospital, University of Rochester Medical Center, Rochester, NY, USA
xi
