{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T22:04:01Z","timestamp":1775167441479,"version":"3.50.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ital J Pediatr"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We report a pediatric patient presenting in good general condition despite a hemoglobin value of 1,9\u2009g\/dL, which is normally regarded as life-threatening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>An African 5\u2009years-old girl presented to our Emergency Department (ED) for worsening asthenia, within a clinical picture of good general condition. The hemoglobin value at admission was 1,9\u2009g\/dL. The subsequent diagnostic-therapeutic pathway highlighted the presence of two different causes, both well known to be responsible for chronic anemia (with slow reduction of hemoglobin values): iron deficiency anemia (IDA) due to a very low dietary intake of iron-rich foods, and homozygous sickle cell disease (HbSS). She received transfusions of packed red blood cells (overall 15\u2009ml\/kg) and subsequently intravenous iron preparations (total amount 200\u2009mg) followed by oral iron supplements. The Hb value at discharge, 10\u2009days after the admission, was 9.8\u2009g\/dL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When approaching a picture of severe anemia, we suggest pediatricians take into consideration clinical conditions rather than laboratory values and to take advantage of detailed anamnestic data in order to make the diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13052-021-01146-w","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T13:22:00Z","timestamp":1633612920000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hemoglobin life-threatening value (1.9\u2009g\/dl) in good general condition: a pediatric case-report"],"prefix":"10.1186","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4260-2689","authenticated-orcid":false,"given":"Emilia","family":"Parodi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Riboldi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ugo","family":"Ramenghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"1146_CR1","unstructured":"World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment ofseverity. Geneva: World Health Organizatio; 2011. Avaiable at https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/85839\/WHO_NMH_NHD_MNM_11.1_eng.pdf?sequence=22&isAllowed=y."},{"key":"1146_CR2","volume-title":"Worldwide prevalence of anemia 1993-2005: WHO global database on anemia","author":"ML DeBenoist","year":"2008","unstructured":"DeBenoist ML, Egli I, et al. Worldwide prevalence of anemia 1993-2005: WHO global database on anemia. Geneva: World Health Organization; 2008."},{"key":"1146_CR3","unstructured":"Brugnara C, Oski FA, Nathan DG. Diagnostic approach to the anemic patient. In: Nathan and Oski's Hematology and Oncology of Infancy and Childhood, 8th ed, Orkin SH, Fisher DE, Look T, Lux SE, Ginsburg D, Nathan DG, et AL (Eds). Philadelphia: WB Saunders; 2015. p. 293."},{"key":"1146_CR4","doi-asserted-by":"crossref","unstructured":"A G. Molinari et al. A Practical Approach to the Use of Low Molecular Weight Heparins in VTE Treatment and Prophylaxis in Children and NewbornsPediatric Hematology and Oncology, 2015; 32:1:10.","DOI":"10.3109\/08880018.2014.960119"},{"key":"1146_CR5","unstructured":"Sandoval C. Approach to the child with anemia. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. 2020."},{"issue":"4","key":"1146_CR6","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1542\/peds.2015-2567","volume":"136","author":"AL Siu","year":"2015","unstructured":"Siu AL. US preventive services task force. Screening for Iron Deficiency Anemia in Young Children: USPSTF Recommendation Statement Pediatrics. 2015;136(4):746\u201352. https:\/\/doi.org\/10.1542\/peds.2015-2567.","journal-title":"Screening for Iron Deficiency Anemia in Young Children: USPSTF Recommendation Statement Pediatrics"},{"key":"1146_CR7","first-page":"270","volume":"93","author":"M Wang","year":"2016","unstructured":"Wang M. Iron deficiency and other types of Anemia in infants and children. Am Fam Physician. 2016;93:270.","journal-title":"Am Fam Physician"},{"key":"1146_CR8","doi-asserted-by":"crossref","unstructured":"Russo et al. Monitoring oral iron therapy in children with iron deficiency anemia: an observational, prospective, multicentre study of AIEOP patients. Ann Hematol. 2020;99(3):413\u201320.","DOI":"10.1007\/s00277-020-03906-w"},{"key":"1146_CR9","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1542\/peds.98.6.1138","volume":"98","author":"M Boutry","year":"1996","unstructured":"Boutry M, Needlman R. Use of diet history in the screening of iron deficiency. Pediatrics. 1996;98:113.","journal-title":"Pediatrics."},{"issue":"6","key":"1146_CR10","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1097\/MPH.0b013e3182588996","volume":"34","author":"E Parodi","year":"2012","unstructured":"Parodi E, Giraudo MT, Davitto M, Ansaldi G, Mondino A, Garbarini L, et al. Reticulocyte parameters: markers of early response to oral treatment in children with severe iron-deficiency anemia. J Pediatr Hematol Oncol. 2012;34(6):249\u201352. https:\/\/doi.org\/10.1097\/MPH.0b013e3182588996.","journal-title":"J Pediatr Hematol Oncol"},{"key":"1146_CR11","doi-asserted-by":"publisher","unstructured":"Chami N, Hau DK, Masoza TS, Smart LR, Kayange NM, Hokororo A, et al. Very severe anemia and oneyear mortality outcome after hospitalization in Tanzanian children: A prospective cohort study. PLoS ONE. 2019;14(6):e0214563. https:\/\/doi.org\/10.1371\/journal.pone.0214563.","DOI":"10.1371\/journal.pone.0214563."},{"key":"1146_CR12","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s12878-015-0033-5","volume":"15","author":"R Simbauranga","year":"2015","unstructured":"Simbauranga R, et al. Prevalence and factors associated with severe anaemia amongst under-five children hospitalized at Bugando Medical Centre, Mwanza, Tanzania. 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