UC Davis Health
Department of Pediatrics

Hematology | Pediagogy Podcast | Department of Pediatrics | UC Davis Health

Hematology

  • Autoimmune Hemolytic Anemia

    Don't miss this cause of anemia in your differential in today’s episode about autoimmune hemolytic anemia!

    Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.com

    This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Anjali Pawar (UC Davis pediatric hematology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Autoimmune hemolytic anemia is an extravascular hemolysis
    • Symptoms can include pallor, fatigue, lightheadedness, jaundice, tachycardia, acrocyanosis, dark urine, splenomegaly, and gallstones with labs showing anemia with schistocytes, reticulocytosis, hyperbilirubinemia, elevated LDH, elevated AST, and positive Coombs testing.
    • AIHA can be triggered by infections, underlying autoimmune diseases, malignancy, immunosuppression, and medications.
    • Treatment is steroids or rituximab for warm AIHA and avoiding the cold for cold AIHA. In refractory cases, splenectomy or stem cell transplant may be needed. Transfusions are generally not recommended due to ongoing hemolysis unless anemia is severe.

    Sources:

    • Voulgaridou A, Kalfa TA. Autoimmune Hemolytic Anemia in the Pediatric Setting. J Clin Med. 2021;10(2):216. Published 2021 Jan 9. doi:10.3390/jcm10020216
    • Noronha, Suzie A. "Acquired and congenital hemolytic anemia." Pediatrics in Review 37.6 (2016): 235-246. doi: 10.1542/pir.2015-0053

  • Iron Deficiency Anemia

    Join us today where we discuss one of the most common causes of microcytic anemia in pediatric patients.

    This episode was written by Tammy Yau and Lidia Park, with content support from Anjali Pawar, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Excessive milk consumption inhibits iron absorption. Limit to 16-24 oz/day
    • Iron supplementation dosing depends on gestational age and major food source. Prevention vs treatment dosing also differ.
    • Mentzer index greater than 13 indicates iron deficiency anemia

    Supplemental information:

  • Newborn Jaundice Part 1

    In the first installment of this 2-part episode, we break down the causes of unconjugated (indirect) and conjugated (direct) hyperbilirubinemia.

    This episode was written by Tammy Yau and Lidia Park, with content support from Daphne Say, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Unconjugated hyperbilirubinemia causes are due to increased bilirubin production, decreased liver conjugation, or decreased clearance
    • Conjugated hyperbilirubinemia can be due to outflow or transport problem, infection, metabolic disorders, liver dysfunction, and parenteral nutrition
    • Always consider biliary atresia in a newborn with pale white stools. The earlier the surgical treatment, the better outcomes

    Supplemental Information:

  • Newborn Jaundice Part 2

    Learn about management of newborn jaundice in our 2-part series.

    This episode was written by Tammy Yau and Lidia Park, with content support from Daphne Say, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Unconjugated bilirubin is fat soluble so can cross the blood brain barrier and cause kernicterus
    • Check bilirubin levels at least every 24 hours while a newborn is first hospitalized
    • New AAP guidelines on hyperbilirubinemia management raised phototherapy and exchange transfusion thresholds
    • Transcutaneous bilirubin monitoring has a +/- 3 margin of error

    Supplemental Information:

  • Sickle Cell Disease Maintenance

    In part 1 of this 2 part series on sickle cell disease, we’re going to discuss the general pediatric management of a patient with sickle cell disease including what special precautions and additional routine health maintenance they need.

    Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bsky.social, and connect with us at pediagogypod@gmail.com

    This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Anjali Pawar (UC Davis pediatric hematologist). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Patients with sickle cell disease should receive penicillin prophylaxis from 2 months old til 5 years old or until pneumococcal vaccine series is completed
    • For patients with HbSS or sickle beta zero thalassemia, offer hydroxyurea at 9 months of age, even if they don’t have clinical symptoms. They should also receive stroke risk screening with an annual transcranial doppler
    • Patients with sickle cell disease should receive annual screening for retinopathy and nephropathy around age 10
    • Patients with sickle cell disease should receive an additional pneumococcal (20 or 23) vaccine and the meningococcal ACWY vaccine at age 10 and men B after age 10 if they have functional asplenia or a splenectomy

    Sources: