Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Mar;145(3):e20190391.
doi: 10.1542/peds.2019-0391. Epub 2020 Feb 20.

A Case of a 15-Month-Old With Periorbital Edema and Severe Anemia

Audrey D Kamzan  1 , Charles A Newcomer  2 , Laura J Wozniak  2 , Noah C Federman  2 , Lydia S Kim  2
Affiliations
Case Reports

A Case of a 15-Month-Old With Periorbital Edema and Severe Anemia

Audrey D Kamzan et al. Pediatrics. 2020 Mar.

Abstract

This is the case of a previously healthy 15-month-old girl who initially presented to her primary pediatrician with a 2-week history of intermittent periorbital edema. The edema had improved by the time of the visit, and a urine specimen was unable to be obtained in the clinic. A routine fingerstick demonstrated anemia to 8.8 mg/dL, so the patient was started on ferrous sulfate. She then returned to the emergency department 1 month later with severe periorbital edema and pallor but no other significant symptoms. On physical examination, she was tachycardic with striking periorbital edema and an otherwise normal physical examination. She was noted to have a severe microcytic anemia (hemoglobin of 3.9 mg/dL and mean corpuscular volume of 53.1 fL) and hypoalbuminemia (albumin of 1.9 g/dL and total protein of 3.3 g/dL). The remainder of her electrolytes and liver function test results were within normal limits. A urinalysis was sent, which was negative for protein. Our panel of experts reviews her case to determine a unifying diagnosis for both her severe anemia and her hypoalbuminemia.

PubMed Disclaimer

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Case laboratory values over time.
See this image and copyright information in PMC

References

    1. Oski FA. Iron deficiency in infancy and childhood. N Engl J Med. 1993;329(3): 190–193 - PubMed
    1. Reeves JD. Prediction of therapeutic response to iron. In: Oski FA, Pearson HA, eds. Iron Nutrition Revisited–Infancy, Childhood, Adolescence: Report of the Eighty-Second Ross Conference on Pediatric Research. Columbus, OH: Ross Laboratories; 1981:114–125
    1. Andreu G Transfusion-associated circulatory overload and transfusion-related acute lung injury: diagnosis, pathophysiology, management and prevention. ISBT Sci Ser. 2009;4:63–71
    1. Alam A, Lin Y, Lima A, Hansen M, Callum JL. The prevention of transfusion-associated circulatory overload. Transfus Med Rev. 2013;27(2):105–112 - PubMed
    1. Agrawal AK, Hsu E, Quirolo K, Neumayr LD, Flori HR. Red blood cell transfusion in pediatric patients with severe chronic anemia: how slow is necessary? Pediatr Blood Cancer. 2012; 58(3):466–468 - PubMed

Publication types