Iron deficiency anemia in a group of Turkish adolescents: frequency and contributing factors

Need for iron increases rapidly during adolescence. In girls, this is primarily due to the beginning of menstruation and dieting to loose weight, while in boys increased erythropoetic activity during pubertal period is the major cause. Between November 1999 and June 2000, 2,900 patients, between 9-17 years of age were screened for the presence of anemia in our Adolescent Outpatient Clinic. Tanner's scale of sexual maturation was used to categorize genital development. Those patients diagnosed with anemia were further examined for bone age, history of pica, parasitosis and gastrointestinal symptoms. Complete blood count showed anemia in 44 patients. Twenty one patients (15 girls and 6 boys) were diagnosed with iron deficiency anemia, 19 (15 girls and 4 boys) were diagnosed with anemia associated with infections, 3 (two girls and one boy) were carriers for beta-thalasemia and one girl had acute myeloblastic leukemia. Laboratory parameters alone were not enough in the diagnosis of iron deficiency, but age, sex, growth rate and sexual maturation stage in the pubertal period must be taken into consideration. We suggest that the reason for the lower rate of iron deficiency anemia in our patients, than expected for this age group, could be due to our patient population being more aware and careful about a balanced diet compared to the feeding behaviour of the general population in Turkey. Further studies that include lower socio-economic groups are necessary to conclude the prevalance of iron deficiency anemia among adolescents.