ANEMIJA I DEFICIT GVOŽĐA U ADOLESCENCIJI: LABORATORIJSKA DIJAGNOSTIKA I PATIENT BLOOD MANAGEMENT PRISTUP
DOI:
https://doi.org/10.46793/PP260202007PKljučne reči:
adolescencija, anemija, deficit gvožđa, program upravljanja krvlju pacijentaApstrakt
vod: Adolescencija (10–19 godina) je period brzog rasta i pubertetskog sazrevanja, tokom koga se vrednosti hemoglobina polno razlikuju, a potrebe za gvožđem rastu, posebno nakon menarhe. Pošto se deficit gvožđa često razvija pre nego što hemoglobin padne ispod dijagnostičkih pragova, pristup zasnovan samo na hemoglobinu može potceniti smanjenu hematološku rezervu.
Cilj: Prikazati praktične kriterijume za anemiju i deficit gvožđa u adolescenciji i prevesti ih u izvodljivu PBM kliničku putanju za svakodnevnu praksu..
Metod: Narativni pregled ključnih međunarodnih smernica i odabranih novijih publikacija, uz fokus na tri interpretativna domena koja uključuju rezerve gvožđa, raspoloživost gvožđa za eritropoezu i inflamatorni konforni efekat..
Rezultati: Klinički značajan deficit gvožđa često postoji bez jasne anemije, naročito kod adolescentkinja. Minimalni laboratorijski paket zato treba da proširi procenu izvan kompletne krvne slike i uključi serumski feritin i zasićenje transferina, uz C-reaktivni protein kada se sumnja na inflamaciju, kako bi se izbegao lažno povišen feritin. Obilna menstrualna krvarenja predstavljaju najpraktičniji okidač za ranu evaluaciju i terapiju gde dodatno visokorizične situacije uključuju hronična inflamatorna oboljenja i malapsorpciju.
Zaključak: PBM u adolescenciji je najefikasniji kada se sprovodi ranim prepoznavanjem rizika, potvrdom deficita gvožđa i uzroka, pravovremenim uvođenjem terapije gvožđem i dokumentovanjem odgovora do korekcije rezervi. Transfuzija eritrocita treba da bude rezervisana za jasno indikovana akutna stanja, a ne da zameni zakasnelo etiološko zbrinjavanje.
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