• Pallor is defined as paleness of the skin and may be a reflection of anemia or poor peripheral perfusion.
  • The normal range for hemoglobin is age-dependent.
  • Anemia can be defined functionally as the inability of hemoglobin to meet cellular oxygen demand.
  • Parents often fail to notice pallor of gradual onset.
    • Grandparents or others who see the child less often may be the first to suspect pallor.

Risk Factors

  • Ages between 6 months and 3 years or adolescent females
    • Peak age ranges for iron deficiency
  • Gender
    • Some red cell–enzyme X-linked defects such as glucose-6-phosphate dehydrogenase (G6PD) and phosphoglycerate kinase deficiencies are sex linked.
  • Race
    • African: hemoglobins S and C, α- and β-thalassemia trait, G6PD deficiency
    • Southeast Asian: hemoglobin E and α-thalassemia
    • Mediterranean descent: β-thalassemia and G6PD deficiency


Familial history: Some of the congenital hemolytic anemias are autosomal dominant.

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