ETIOLOGICAL SPECTRUM OF ANEMIA AMONG ADOLESCENTS IN TÜRKIYE: INSIGHTS FROM A TERTIARY CARE CENTER
ETIOLOGICAL SPECTRUM OF ANEMIA AMONG ADOLESCENTS IN TÜRKIYE: INSIGHTS FROM A TERTIARY CARE CENTER

Summary/Abstract: Background: Adolescent anemia is a global public health concern, disproportionately affecting low- and middle-income countries. Despite this burden, Türkiye lacks a national screening or supplementation program targeting this age group.Aim of the study: The aim of this study was to investigate the etiological spectrum and clinical characteristics of anemia in adolescents aged 10–18 years referred to a tertiary pediatric hematology clinic in Türkiye.Material and methods: This retrospective study evaluated 356 adolescents diagnosed with anemia at Bursa City Hospital between August 2020 and September 2023. Demographic, clinical, and laboratory data – including serum iron, ferritin, vitamin B12, and folate levels – were analyzed. Anemia was defined according to WHO thresholds.Results: The mean age was 14.07±1.96 years, and 81.5% of the patients were female. Iron deficiency anemia (IDA) was the most prevalent etiology (74.4%). Borderline or overt vitamin B12 deficiency was detected in 27.8% of patients, and folate deficiency in 8.7%. Combined nutritional deficiencies were present in 24% of patients. Genetic anemias, particularly beta-thalassemia trait (14.9%), were also observed. Approximately 23.6% of the patients were asymptomatic at diagnosis, and excessive menstrual bleeding was a common contributing factor among girls. IDA was significantly associated with older age and female gender (p<0.001).Conclusions: Nutritional deficiencies – especially iron, vitamin B12, and folate deficiencies – remain the leading causes of adolescent anemia in Türkiye. The high rate of asymptomatic cases and coexisting micronutrient deficiencies underscores the need for national, age- and gender-sensitive screening and supplementation strategies. These findings may support the development of targeted, age- and sex-sensitive screening and nutritional assessment strategies for adolescents, particularly in high-risk clinical populations.

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