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    The correlation between inflammatory diseases determined by ESR and CRP levels and the severity of anemia in pediatric age-groups
    (Maltepe Üniversitesi, 2019) Nake, A.; Pistulli, E.; Puja, A.; Spahiu, A.
    Introduction: Anemia is a common blood condition that affects populations in both rich and poor countries. The most prevalent anemia after iron deficiency anemia is the anemia of chronic disease. It is usually observed as a non-specific anemia in patients with infectious, inflammatory and neoplastic diseases, and may cause diagnostic challenges. Routine diagnostic tests are performed in these patients, but recently, new blood markers such as hepcidin antimicrobial peptide are used to evaluate the severity of the disease. To evaluate the association between inflammatory disease and the potential risk for anemia in pediatric age-groups. Materials and Methods: In this study were involved 64 children aged 0 to 18 years old, hospitalized in ‘’Pediatric Service’’, the University Medical Center of Tirana “Mother Teresa”, during May 2018. Patients were diagnosed with diseases associated with the inflammatory process. Complete blood count (CBC) tests and other tests that detect inflammation such as C-Reactive Protein and Erythrocyte Sedimentation Rate (CRP and ESR), were determined in patients with hemoglobin (Hb) levels < 11.5 g/dl. The CBC parameters are measured using Automated Cell Counter machines, ESR is measured using Westergren method, CRP test is based on the principle of the latex agglutination, and the colorimetric method is used for serum iron measurement. All the cases involved in this study were evaluated other examinations and laboratory tests, which were significant in the determination of the diagnosis. Results: The average age of patients included in the study was 2.65 years old among which 56.25% were male and 44.75% were female. 12.5% of patients had blood malignancies, 34.4% had acute bacterial diseases, 18.7% had chronic bacterial diseases, 23.4% had viral infections and 10.9% had autoimmune diseases. Patients with chronic bacterial diseases and viral infections had significantly higher levels of ESR (ESR=29.83, N=0-13mm/h) than others. Levels of CRP were higher in patients with acute bacterial diseases (CRP=52.84, N=3-20mg/dl), and the levels of hemoglobin were lower in patients with autoimmune diseases (Hb=9.14, N=13-16 ±2 mg/ dl). This was presented with a high variance in the values of ESR ( 2 = 286.09) and PCR ( 2= 2002.28). The evaluations revealed a moderate positive correlation between Hb and RBC ( 2=0.15), a mild negative correlation between Hb and ESR, also between Hb and PCR. Results: The time span and the degree of the inflammation which coexists with the underlying disease, determine the type of anemia which associates them. These results suggest that in this pediatric age-group, the treatment should focus on the underlying disease in order to correct anemia.