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Samorodnova, Elena A. "Iron deficiency in children: modern aspects of the problem, possibilities of primary prevention: A review." Pediatrics. Consilium Medicum, no. 4 (January 18, 2023): 302–8. http://dx.doi.org/10.26442/26586630.2022.4.201960.
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Iron deficiency (ID) is common in the pediatric population, primarily due to inadequate iron intake from food and a high requirement due to rapid growth. The most significant for pediatric practice are latent iron deficiency and iron deficiency anemia. Hyposiderosis significantly impacts a child's physical and cognitive development and immunological reactivity. It can be an independent condition and complicate the course of several other diseases. The article presents data on the most significant factors contributing to the ID, risk groups, clinical presentation features (sideropenic and anemic syndromes), criteria of laboratory diagnostics of iron deficiency anemia according to the clinical guidelines "Iron deficiency anemia" approved by the Russian Ministry of Health in 2021, and the latent iron deficiency developed by the World Health Organization experts. Also, the algorithm of ID primary prevention, diet therapy approaches, and the use of functional products and dietary supplements to meet the iron requirement of a child's organism are discussed.
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Khan, Saadia, Imran Iqbal, Asad Abbas, Reema Arshad, Ibad Ali, Sabeeha Khan, and Adan Ijaz. "Parental Iron Therapy to Treat Iron Deficiency Anemia in Malnourished Children." Journal of Islamic International Medical College 17, no. 4 (December 29, 2022): 239–44. http://dx.doi.org/10.57234/691.
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Objective: To evaluate the safety and efficacy of parental iron therapy to treat iron deficiency anemia in malnourished children. Study Design: Quasi experimental design. Place and Duration of Study: Stabilization Centre, Children Hospital and the Institute of Child Health, Multan from 1 December 2014 to 31 December 2020. Materials and Methods: A total of 250 malnourished children with iron deficiency were included in the study. The laboratory parameters i.e., Hemoglobin, Hematocrit, Red Blood Cells Count, mean corpuscular hemoglobin, mean corpuscular volume, and Serum ferritin of all patients were done. Using the iron deficit formula, all participants were given the measured iron sucrose complex. The iron sucrose complex was diluted with 0.9% normal saline and administered steadily for 3-4 hours. After 6 weeks of therapy, hemoglobin, RBC count , ferritin was measured. Comparison of mean ±SD of baseline laboratory parameters and after 6 weeks of iron supplementation was analyzed by using t-test. Results: A total of 250 participants were registered, male patients (57.2%) were more than female patients (42.8 %). Most of the 92(36.8%) participants were 12-24 months old. The key cause of anemia among 102(40.8%) admitted patients was inadequate diet or excessive milk consumption. The mean ±SD value of the Hb level at admission was 7.5±1.9 and it increased to 11±1.15g/dL after 6 weeks of active supplementation which is statistically significant (P-value < 0.05). Six weeks after giving intravenous iron therapy mean serum Ferritin increased from 11.5ml to 21.61 ng/ml. Conclusion: Current study concluded that controlled administration of IV iron sucrose for treatment of iron deficiency anemia among inpatients is efficacious and safe. IV iron sucrose should be considered for patient with severe IDA, those who are not compliant with oral formulations, and patients with malabsorption.
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Lakkaraja, Madhavi, Lesley Small, Maura Frank, Aliza Solomon, Nicole Kucine, and James B. Bussel. "Iron Deficiency Anemia in Infants and Toddlers – Role of Milk and Constipation." Blood 120, no. 21 (November 16, 2012): 5171. http://dx.doi.org/10.1182/blood.v120.21.5171.5171.
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Abstract Abstract 5171 Introduction: One of the most common nutritional deficiencies in the world is iron-deficiency anemia and young children are at high risk of developing it. In spite of fortification of foods in the United States, there is a high prevalence of anemia in infants and toddlers increasing their risk of neuro-developmental effects. Constipation is defined as delay or difficulty in defecation ≥ 2 weeks. Around one year of age, various changes are commonly implemented in a child's diet including introduction of whole milk and solids. Children may then present with sub-clinical colitis, constipation and anemia secondary to blood loss in stool or develop anemia due to increased consumption of milk. The American Academy of Pediatrics (AAP) recommends screening for anemia at 1 year and 2 year visits. The only clue to intolerance to milk may be symptomatic constipation and treating the anemia and switching the type of milk often helps to resolve this problem. This study explores the relation between iron deficiency, constipation and milk. Methods: This is an ongoing prospective study, which has been extended from Cornell to different centers. Data presented here is only from the Cornell principal site. Children between 6 months and 30 months visiting the resident's pediatric clinic and having routine blood work drawn as a part of their visit were included in the study. The National Health Sciences (NHS) Constipation questionnaire was administered to the parents of these children; ≥ 2 was considered Constipation. In addition, a detailed diet history of the child, and history of medicines and illness was taken and questions were asked about family history of anemia, constipation and allergies. If the mother was breast feeding, questions were asked about her dairy intake. Comparisons were made between children with and without constipation/iron deficiency. If the child had Hemoglobin (Hgb) <11, the child was started on Iron as per clinic policy, and phone calls were made to check for compliance with Iron. In addition letters including a printed calendar and a note on Iron rich foods were mailed out to the parents. Results: Two hundred five children, 92 females and 113 males between 8 and 30 months mean age 16. 7 months, are enrolled in the study. Seventy-two children (35 %) were constipated (score ≥2). Forty-two children (20. 5%) had Hgb <11. Children who had Hgb < 11 were not more constipated (45%) than those who had Hgb ≥11 (35%). In the Hgb <11 group, there was no significant difference in Hgb between children with and without constipation (p = 0. 19), however there was a difference in Hgb between infants with a Constipation score 0 and score 1 (p = 0. 03). Of the 42 children who had Hgb <11, 3 were later found to have sickle trait or alpha thalassemia trait, which were identified when iron intake did not improve the Hgb level. Compliance with Iron: Of the 39 children who were on Iron, 9 parents could not be reached via phone. Only 6 parents gave no Iron at all but another 12 did not give Iron properly resulting in 18/30 or 60% of infants/toddlers not receiving an adequate trial of replacement Iron. Among the side effects of Iron, one parent felt Iron caused rash on back and wanted multivitamin with Iron after finishing a month's course, one child had discoloration of teeth, so the parent gave it with juice. Two parents with infants with apparent true milk protein allergy colitis said constipation improved with diet change and iron. Conclusions: The prevalence of mild anemia is high in infants and toddlers. There was no clear association of constipation and anemia. Compliance is one of the key factors for Iron replacement therapy and in view of how erratic compliance was, it is imperative to give proper instructions to the parent while prescribing Iron. Material to better indicate which foods were rich in iron and follow-up phone calls were included in the management to optimize iron intake of anemic children. We will include more patients, more closely monitor the change in the diet of the child, and monitor responses to Iron therapy in children with low Hgb. In addition, different practices at other involved centers e. g. Brooklyn hospital Center may allow comparison of the time of screening (9 months v/s 1 year) and testing with Hemoglobin/Hematocrit versus a full Complete Blood Count with indices. Disclosures: Bussel: Amgen: Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Research Funding; Cangene: Research Funding; GlaxoSmithKline: Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Research Funding; Genzyme: Research Funding; IgG of America: Research Funding; Immunomedics: Research Funding; Ligand: Membership on an entity's Board of Directors or advisory committees, Research Funding; Eisai, Inc: Membership on an entity's Board of Directors or advisory committees, Research Funding; Shinogi: Membership on an entity's Board of Directors or advisory committees, Research Funding; Symphogen: Membership on an entity's Board of Directors or advisory committees; Sysmex: Research Funding; Portola: Consultancy.
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Kazancı, Elif Güler, Muhammet Furkan Korkmaz, and Betül Orhaner. "Efficacy and safety of intravenous iron sucrose treatment in children with iron deficiency anemia." Medical Science and Discovery 6, no. 10 (October 27, 2019): 278–83. http://dx.doi.org/10.36472/msd.v6i10.317.
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Objective: The purpose of this study is to investigate the efficacy and safety of intravenous iron sucrose treatment in children with iron deficiency anemia who were unresponsive to or could not tolerate oral iron therapy.
Material and Methods: Among patients determined to have iron deficiency anemia, and were intolerant or noncompliant with oral iron therapy, 92 patients who have received parenteral iron therapy between the ages of 6 months and 18 years have been investigated retrospectively. Age, gender, patient complaints at application, dietary characteristics, accompanying diseases and treatment complications, and safety, tolerability, and adverse events have been assessed from the information obtained from patient files. Treatment efficiency was evaluated with hemoglobin (Hb), mean corpuscular volume (MCV) and ferritin results from the blood samples taken before treatment, at the second week of treatment and after two months.
Results: Mean age of patients was 12.5 ± 4.7 (age interval 1-17 years), and 21% was male while 79% was female. 72% of our patients were adolescents. From an etiological aspect, 56% of our patients was determined to have an iron-poor diet, 29% had functional menorrhagia, and 15% had chronic gastrointestinal system pathologies. Mean Hb, MCV and ferritin levels before and after treatment were found as: 7.72 ± 1.21 g/dl and 11.44 g/dl ± 0.68 g/dl; 63.2 ± 7.12 fL and 76.6 ± 3.81 fL; 3.87 ± 2.52 nmol/L and 57.94 ± 17.19 nmol/L, respectively (p< 0.001). 94% of patients were determined to have at least 2 g/dL (mean value 3.71 [range 1.6-6.3]) increase in their Hb levels. Anaphylaxis was observed in a patient who had a history of allergy despite applying premedication.
Conclusion: Parenteral iron therapy is an efficient and safe treatment among indicated patients.
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Moscheo, Carla, Elisa Fenizia, Mariaclaudia Meli, and Giovanna Russo. "Anemia sideropenica in età pediatrica: pillole di… ferro." QUADERNI ACP 28, no. 4 (2021): 173. http://dx.doi.org/10.53141/qacp.2021.176-180.
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Iron deficiency anemia is the most frequent haematological disorder in children. Although much is already known about the diagnostic-therapeutic approach, new frontiers regarding its diagnosis and therapeutic options emerge every day. An adequate intake with the diet is essential and can also be obtained in compliance with vegetarian-type diets. The use of glycinate or lysosomal preparations could positively affect the efficacy of therapy reducing the side effects associated with commonly used iron preparations. Parenteral iron therapy in pediatric age, which is currently limited to selected conditions, may evolve further, as a consequence of the production of molecules such as ferrocarboxymaltose, the use of which is not currently permitted under the age of 14. Further studies are therefore necessary in order to implement the knowledge and diagnostic-therapeutic interventions related to this widespread nosological entity.
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Daniel, Catherine, Ellen S. Plummer, and George R. Buchanan. "Deficiencies in the Management of Iron Deficiency Anemia During Childhood." Blood 118, no. 21 (November 18, 2011): 3154. http://dx.doi.org/10.1182/blood.v118.21.3154.3154.
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Abstract Abstract 3154 Background: Iron deficiency anemia (IDA) is a common hematologic problem worldwide, potentially leading to cognitive delays, fatigue, seizures, and, when severe, high output heart failure. While IDA frequently is encountered in both the primary care setting and specialty clinics, its management is not evidence based. As a result, the diagnosis and treatment of IDA is often suboptimal. To help inform future clinical trials, we retrospectively characterized the clinical course of IDA in young patients (pts) referred to our center. Methods: Using our comprehensive hematology database, the records of children ≤ 18 years (yrs) of age with IDA seen in our outpatient clinic between January 1, 2006 and June 30, 2010 were identified and carefully reviewed. Results: Of 217 IDA pts in the database, 215 had evaluable records, 20 of whom were determined to have an alternative diagnosis. Of 195 evaluable pts, 64% were ≤4 yrs old at their first clinic visit and 31% were age 11–18 yrs. Pts ≤ age 4 yrs were 63% male and 60% Hispanic, whereas those age 11–18 yrs were 83% female and 37% Hispanic, 35% African-American, and 15% Caucasian. Causes of IDA in 128 pts ≤ 4 yrs were excessive consumption of cow milk (68%), breast feeding without iron supplementation (13%), overall iron-poor diet beyond 12 months (16%), prematurity (5%), and suspected malabsorption (6%). Causes of IDA in 60 pts aged 11–18 yrs were menorrhagia (43%), other blood loss (20%), iron-poor diet (22%), and poor iron absorption (7%). Some pts in both age groups had multiple causes of IDA, and in 17 the cause of the anemia was not clear. 129 pts (66%) were referred to us directly by their primary care physician (PCP), and 49 (25%) by the emergency department (ED), 37 of whom had been sent there by their PCP for evaluation of anemia. Prior to their first visit to our center, 115 pts (59%) had received at least one trial of iron therapy, 62 with ferrous sulfate, 27 with carbonyl iron, 5 with iron polysaccharide, and 15 with an iron-containing multivitamin. For the pts ≤ 4 yrs of age where the precise dose of elemental iron prescribed by the PCP was known (n=59), greater than half of the pts were prescribed doses of iron outside of the accepted therapeutic range (3–6 mg/kg/day) (see figure). The pts' mean Hb concentration before referral to our clinic (last recorded Hb measured either by the PCP or the ED) was 7.8 g/dl (n=170). Following evaluation in our hematology clinic, 86% of patients were treated with ferrous sulfate. However, 17% of such pts ≤ 4 yrs of age still received iron doses outside of the accepted therapeutic range. At the time of their first and last visits to the hematology clinic the mean Hb values were 9.0 g/dl and 11.3 g/dl respectively. One third of pts had documented poor adherence with iron therapy, due to poor tolerability (19%), gastrointestinal upset (11%), misunderstanding of prescribed dose (14%), and use of a lower dose than prescribed due to parental discretion (41%). 40% of pts were lost to follow up. Summary and Conclusions: Among pts referred for IDA to our academic specialty clinic, Hispanic male toddlers and Hispanic or African-American female adolescents were disproportionately represented. Most toddlers had nutritional IDA while most adolescents had menorrhagia. Pts often received sub-therapeutic doses of iron before referral. After hematology clinic evaluation, most children demonstrated improvement of IDA; however, inappropriate dosing and non-adherence with oral iron therapy were high, and many pts were lost to follow up. Insufficient screening and prevention of IDA remains problematic. Additionally, when IDA is suspected it is often inadequately treated or inappropriately referred to the ED or the hematology clinic, where treatment is associated with poor adherence and high attrition rates. Future research must focus on all of these deficiencies to prevent the many immediate and long-term sequelae of IDA. Disclosures: No relevant conflicts of interest to declare.
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Powers, Jacquelyn M., Timothy L. Mccavit, Leah Adix, and George R. Buchanan. "Low Dose Once Daily Oral Iron Treatment of Young Children with Nutritional Iron Deficiency Anemia." Blood 126, no. 23 (December 3, 2015): 2147. http://dx.doi.org/10.1182/blood.v126.23.2147.2147.
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Abstract Background Iron deficiency anemia (IDA) is prevalent in young children whose diet includes prolonged breast feeding without iron supplementation and/or excessive cow milk consumption. Oral iron therapy is recommended to correct the anemia and reconstitute iron stores, but few data exist to guide clinical decision-making. The recommended dosing of elemental iron has been inconsistent in the literature, ranging from 2 to 6 mg/kg/day, given one to three times daily. To address the paucity of treatment data, the BESTIRON study (Clinicaltrials.gov NCT01904864) was initiated to compare two liquid oral iron agents (ferrous sulfate and NovaFerrum, an iron polysaccharide) using a once daily, low-dose regimen. Methods This study is a single center, double-blinded, randomized controlled superiority trial. Inclusion criteria include: age 9 months to 4 years with nutritional IDA by history and laboratory indices (Hgb <10 g/dL, MCV <70 fl, reticulocyte hemoglobin equivalent (Ret He) <25 pg, serum ferritin <15 ng/mL and/or TIBC >425 mg/dL). Exclusion criteria include: evidence of blood loss, malabsorption, other cause of anemia, prematurity (gestational age <30 weeks), major co-morbidity, adequate response to prior iron therapy, or previous receipt of intravenous iron. Upon enrollment, subjects are randomized 1:1 to either ferrous sulfate (15 mg/mL) or NovaFerrum (15 mg/mL) dosed at 3 mg/kg elemental iron once daily at bedtime. Follow-up visits occur at 4, 8, and 12 weeks following study initiation. Definition of complete response at study exit is: Hgb >11 g/dL, MCV >70 fl, Ret He >25 pg, serum ferritin >15 ng/mL, and TIBC <425 mg/dL. The primary outcome, rate of change in hemoglobin concentration over 12 weeks, cannot yet be determined as enrollment is ongoing. Here we present the overall combined hematologic response to this "minimalist" treatment regimen for subjects who have completed the study to date. Results From 9/1/2013 to 8/1/2015, 72 patients (target accrual 80) enrolled in the study. Sixty-two subjects (56% male) completed it and are included in the analysis. Median age was 19 months (range 11 - 41 months). Subjects were predominantly Caucasian/White (Latino) (61%). Median baseline and week 12 laboratory values are shown in the Table. Thirteen patients received a transfusion for severe symptomatic anemia (median Hgb 3.6 g/dL, range 2.2 - 5.3 g/dL) prior to study entry. Forty-six of the 62 subjects (74%) completed all 3 study follow-up visits. Eleven subjects were lost to follow-up or discontinued study participation. Five others were considered treatment failures at 8 weeks (hemoglobin increment <0.5 g/dL above baseline) and removed from the study. Of the 46 subjects who completed all study visits, 20 (43%) met the definition of complete resolution (38% of subjects with baseline hemoglobin <8 g/dL compared to 50% among those with baseline hemoglobin >8 g/dL) and received no further iron therapy. Conclusion This analysis of children with nutritional IDA receiving a "patient-friendly" regimen of a single daily dose of 3 mg/kg elemental iron for 12 weeks demonstrates a good hematologic response and suggests that higher doses of iron therapy are not necessary to achieve resolution of anemia. While most subjects achieved a normal hemoglobin concentration, some required continued iron therapy to assure repletion of iron stores. Adverse effects ascribed to oral iron treatment may result in part from prescribing higher or more frequent iron doses, which may contribute to poor adherence and treatment failure. We acknowledge Gensavis Pharmaceuticals, LLC for their support of this investigator-initiated study. Table 1. Median Laboratory Values at Baseline and Week 12 Baseline (N=62) Median (Range) Week 12 (N=46) Median (Range) Hemoglobin concentration (g/dL) 8.0 (4.4 - 10.6) 11.9 (9.0 - 13.6) Mean cell volume (fl) 59.9 (47.3 - 69.8) 72.0 (54.7 - 81.9) Red cell distribution width (%) Baseline (n=56), Week 12 (n=46) 21.1 (15.5 - 36.5) 18.7 (12.5 - 26.4) Reticulocyte count (%) Baseline (n=60), Week 12 (n=45) 1.4 (0.3 - 3.9) 0.9 (0.4 - 1.8) Reticulocyte hemoglobin equivalent (pg) Baseline (n=41), Week 12 (n=40) 17.2 (10.6 - 28.4) 29.5 (15.9 - 34.3) Serum iron (mcg/dL) 20 (9 - 349) 51 (15 - 394) Serum ferritin (ng/mL) 2.5 (0.5 - 49.2) 11 (2.4 - 46) Total iron binding capacity (mg/dL) 513 (236 - 636) 394 (287 - 560) Disclosures Powers: Gensavis Pharmaceuticals, LLC: Research Funding. Mccavit:Gensavis Pharmaceuticals, LLC: Research Funding; Pfizer: Speakers Bureau; Novartis: Speakers Bureau. Adix:Gensavis Pharmaceuticals, LLC: Research Funding. Buchanan:Gensavis Pharmaceuticals, LLC: Research Funding.
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Nestor, Jennifer A., Faraz A. Afridi, Richard Suarez, Joey Bou Karem, Michael Hardiman, Krystal Hunter, Christine Rickette, and Rafat Ahmed. "Intravenous Iron Infusions in Pediatric Patients: A Single Institution Assessment of Efficacy and Adverse Effects of IV Iron Infusions." Blood 134, Supplement_1 (November 13, 2019): 5872. http://dx.doi.org/10.1182/blood-2019-123800.
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Background: Iron deficiency, even without a diagnosis of anemia, can be neurodevelopmentally dangerous in pediatric populations. Oral iron supplementation has been the treatment of choice but is associated with poor adherence for several reasons including metallic taste of the tablets, gastric irritation, severe constipation, and daily dosing for several weeks. Intravenous iron has been safely used in adult populations for iron supplementation, but has less commonly been used in pediatric populations. It is hypothesized that pediatric patients with iron deficiency anemia (IDA) who receive intravenous iron infusions will show normalization of hematologic parameters. Methods: EMR of patients aged 1-21 who received at least one intravenous iron infusion at Cooper University Hospital between 2016 and January 2019 were reviewed for retrospective data collection. Pre-infusion lab values including Hgb, MCV, RBCs and RDW were compared to post-infusion values to determine if values normalized after intravenous iron infusion. Patient demographics including ethnicity, cause of IDA, prior oral iron treatments, and adverse effects of oral and IV iron were analyzed. Results: There were 33 subjects in this study. The average age of the subjects was 12.8 (+/- 5.1) years of age and 79% were female. The most prevalent indication for IV iron was menorrhagia (55%), while GI issues were 18% and insufficient diet accounted for 27%. The mean baseline HGB was 8.3 (+/- 1.7) while the mean final HGB increased to 11.5 (+/- 1.4) (p<0.001). The mean baseline MCV was 69.2 (+/- 9.3) and the mean last MCV was 76.1 (+/- 6.8) (p<0.001). The mean baseline RBC was 4.2 (+/- 0.82) and the mean last RBC was 4.9 (+/- 0.6) (p<0.001). Conclusion: IV iron sucrose infusions administered to pediatric outpatients were safe and effective in children and adolescents with IDA. Adherence to intravenous iron did not significantly improve. Hematologic parameters improved with infusions. Further analysis of patient demographics and characteristics of diagnosis needs to be performed to elucidate benefits of this therapy. As a single institution study, the results are limited to a regional patient population and their specific demographics. Disclosures No relevant conflicts of interest to declare.
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Garg, Shipra, Narry Savage, Emmanuel Siaw, and Ashish Patel. "Ménétrier Disease; 2-Year-Old Boy Presenting With Prolonged Emesis, Generalized Edema and Chance Histopathological Finding of Cytomegalovirus Gastritis: A Case Report." Archives of Medical Case Reports and Case Study 4, no. 2 (May 12, 2021): 01–04. http://dx.doi.org/10.31579/2692-9392/029.
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Ménétrier disease (MD) is characterized by enlarged gastric folds with associated protein losing gastropathy. In children it is a rare and self-limited cause of protein losing gastropathy. We report a case of a 2-year-old male who presented with prolonged, refractory emesis and peripheral edema. Workup revealed severe hypoalbuminemia, hypoproteinemia, iron deficiency anemia, and high stool alpha-1 antitrypsin. Hepatic protein synthesis was normal with no urinary protein loss. Endoscopy showed antrum sparing, severe erosive gastritis in body and fundus, characteristic of MD. Histologic examination displayed inflammation with eosinophilia, foveolar hyperplasia, atrophic oxyntic epithelium, and rare CMV inclusions. Patient received antiviral therapy, intravenous albumin, diuretic and was discharged on high protein diet. Follow-up revealed clinical recovery, with endoscopy and histology showing normal gastric mucosa throughout the stomach. It is important to remain vigilant of this condition in pediatric population and to include it in the differential diagnosis in cases of protein losing gastroenteropathy.
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Garg, Shipra. "Ménétrier Disease; 2-Year-Old Boy Presenting With Prolonged Emesis, Generalized Edema and Chance Histopathological Finding of Cytomegalovirus Gastritis: A Case Report." Archives of Medical Case Reports and Case Study 4, no. 2 (May 12, 2021): 01–05. http://dx.doi.org/10.31579/2694-0248/029.
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Ménétrier disease (MD) is characterized by enlarged gastric folds with associated protein losing gastropathy. In children it is a rare and self-limited cause of protein losing gastropathy. We report a case of a 2-year-old male who presented with prolonged, refractory emesis and peripheral edema. Workup revealed severe hypoalbuminemia, hypoproteinemia, iron deficiency anemia, and high stool alpha-1 antitrypsin. Hepatic protein synthesis was normal with no urinary protein loss. Endoscopy showed antrum sparing, severe erosive gastritis in body and fundus, characteristic of MD. Histologic examination displayed inflammation with eosinophilia, foveolar hyperplasia, atrophic oxyntic epithelium, and rare CMV inclusions. Patient received antiviral therapy, intravenous albumin, diuretic and was discharged on high protein diet. Follow-up revealed clinical recovery, with endoscopy and histology showing normal gastric mucosa throughout the stomach. It is important to remain vigilant of this condition in pediatric population and to include it in the differential diagnosis in cases of protein losing gastroenteropathy.
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Landry, Carmen, Jon Dorling, Ketan Kulkarni, Marsha Campbell-Yeo, Michael Vincer, Joyce Ledwidge, Lisa Morrison, and Satvinder Ghotra. "Risk Factors for Iron Deficiency in Very Preterm Infants at 4-6 Months Corrected Age." Blood 136, Supplement 1 (November 5, 2020): 28. http://dx.doi.org/10.1182/blood-2020-142442.
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Background: Iron is an essential micronutrient, especially in infants and young children and is required for erythropoiesis and development of the central nervous system. However, iron deficiency (ID) is the most common micronutrient deficiency worldwide. ID and iron deficiency anemia (IDA) have been associated with poor neurodevelopmental and behavioural outcomes later in life. Preterm infants are particularly at risk of developing ID in early life due to lower iron stores at birth, accelerated growth in the first weeks of life and multiple phlebotomies while in hospital. Therefore, international recommendations suggest prophylactic iron therapy of 2-4 mg/kg/day starting at 2-6 weeks of age until at least 6-12 months in preterm and low birth weight infants. This prophylactic iron supplementation has been shown to be effective at reducing the incidence of ID and IDA. However, the published work mainly involves moderate to late preterm infants and the research is lacking on iron status after discharge in very preterm infants (VPI, <31 weeks gestational age). Based on our previous work, 32% of the VPIs were iron deficient at 4-6 months corrected age despite this early supplementation. Since the development of ID may have permanent detrimental effects on the developing brain of these high-risk preterm infants, a knowledge of risk factors for ID is also important to identify strategies focused on its prevention. Objective: To investigate the risk factors associated with development of ID Methods: A retrospective cohort study was conducted at the IWK Health Centre using a population based provincial Perinatal Follow-Up Program database. All live-born VPIs born in Nova Scotia between 2005-2018 were included. Patients with congenital malformations, chromosomal anomalies, or who died prior to outcome assessment were excluded. As a standard of care, all these infants were started on prophylactic iron supplements (2-3 mg/kg/day) at 2-4 weeks of chronological age. Iron dosage was regularly adjusted during the hospital stay as guided by serum ferritin levels. At discharge, it was recommended to continue iron prophylaxis until 9-12 months corrected age. All these infants underwent a blood test during their first neonatal follow-up visit at 4-6 months corrected age to check for hemoglobin, reticulocyte count and serum ferritin. ID was defined as serum ferritin <20g/l or <12g/l at 4 and 6 months respectively. A univariate analysis was performed by using a series of single variable logistic regression models to identify the factors associated with presence of ID. Factors with a p-value < 0.20 in the univariate analysis were entered into a multivariable risk model for occurrence of ID using a backwards selection procedure. Variables with a p-value < 0.05 were retained. Results: Of 411 infants included in the study, 32.1% (n=132) had ID. The prevalence of ID decreased over time (37.6% in 2005-2011 vs 25.8% in 2012-2018 cohort). Table 1 compares the antenatal and neonatal characteristics of the ID and non-ID groups. Table 2 compares sociodemographic variables and clinical variables at the time of follow up of the two groups. Independent risk factors for ID were: gestational age (<27 weeks to >27 weeks) (OR:1.7 (1.0-2.9), p=0.04) and gestational hypertension (OR: 2.1(1.2-3.7), p=0.009). Independent factors protective for ID were: mixed feeding (breast milk and formula compared to formula alone) (OR: 0.5 (0.2-0.9), p=0.021) and iron supplementation at follow-up (OR:0.5 (0.3-0.9), p=0.02). Conclusion(s): Despite prophylactic iron supplementation, one-third of VPIs had ID at 4-6 months corrected age. Gestational hypertension in mother and gestational age < 27 weeks were independent risk factors for ID. In addition, despite adjusting for iron supplementation at follow-up, the formula feeding group was more likely to have ID compared to the mixed feeding group. This may be because of the sub-therapeutic iron intake in the formula fed infants. It is often thought that formula milk may have sufficient iron to meet the demands of growing infants and thus, they are less likely to receive higher doses of supplemental iron beyond what is contained in the formula. However, this may not be true since the iron present in formula may not have the same bioavailability as breast milk. Future prospective studies are required to further validate these observations. Nonetheless, the study identified important areas to mitigate ID in VPIs. Disclosures No relevant conflicts of interest to declare.
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Roganović, Jelena. "PARENTERAL IRON THERAPY IN CHILDREN WITH IRON DEFICIENCY ANEMIA." Paediatrics Today 11, no. 1 (March 15, 2015): 24–29. http://dx.doi.org/10.5457/p2005-114.106.
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Roganovic, Jelena, and Elpis Mantadakis. "Parenteral iron therapy in children with iron deficiency anemia." World Journal of Pediatrics 12, no. 1 (January 19, 2016): 122–23. http://dx.doi.org/10.1007/s12519-016-0002-5.
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AHMED, SHAHEEN, Salman Ali, NAEEM FAREED, Mehboob Sultan, NADEEM SADIQ, and Umar Khurshid. "IRON DEFICIENCY ANEMIA." Professional Medical Journal 16, no. 02 (June 10, 2009): 209–15. http://dx.doi.org/10.29309/tpmj/2009.16.02.2903.
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t r o d u c t i o n : The adherence to treatment of iron deficiency anemia often is poor in both developed and developingcountries. The current standard therapy is oral ferrous sulfate administered 3 times daily. It is possible that adherence would improve witha single-dose daily treatment regimen. O b j e c t i v e s : To compare single versus thrice daily ferrous sulfate for treatment of iron deficiencyanemia in young children. D e s i g n : Quasi experimental study Setting: Children Department Military Hospital Rawalpindi. P e r i o d : From (01Jan- to31 Mar 05 and 03 Jul to 02 Oct 05) Subjects and Methods: Total 250 patients of iron deficiency anemia (hemoglobin values: 7.0to 9.9 gm/dl and serum ferritin values: 10 ng/ml or less) were identified. Children divided into two groups and matched on the basis of age;and gender. One group (n = 125) received ferrous sulfate once daily and the control group (n = 125) received ferrous sulfate thrice dailyat a total dose of 6 mg/kg/day of elemental iron for 2 months. Hemoglobin and serum ferritin values were measured as baseline and at theend of the study. R e s u l t s : Successful treatment of anemia (target hemoglobin > 10 gm/dl) occurred in 81.42 % of the single dose and in79.83 % of thrice daily dose groups and the side effects were minimal between the two groups. Conclusion: A single versus a 3 times dailydose of ferrous sulfate resulted in a similar rate of successful treatment of iron deficiency anemia, without significant side effects.
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Gordeuk, VR, GM Brittenham, CE McLaren, MA Hughes, and LJ Keating. "Carbonyl iron therapy for iron deficiency anemia." Blood 67, no. 3 (March 1, 1986): 745–52. http://dx.doi.org/10.1182/blood.v67.3.745.745.
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Abstract To determine if elemental carbonyl iron powder is safe and effective therapy for iron deficiency anemia, 20 nonanemic and 32 anemic volunteers were studied. Single doses of 1,000 to 10,000 mg of carbonyl iron (15 to 150 times the 65 mg of iron in the usual dose of ferrous sulfate) were tolerated by nonanemic volunteers with no evidence of toxicity and only minor gastrointestinal side effects. Anemic volunteers (menstruating women who had previously donated blood) were treated with several regimens providing 1,000 to 3,000 mg of carbonyl iron daily in one to three doses for 8 to 28 days. After 12 weeks anemia was corrected in 29 of 32 patients, and serum ferritin was greater than 12 micrograms/L in 14. Hemoglobin regeneration proceeded at a rate similar to that described for therapy with oral iron salts and parenteral iron dextran. There was no evidence of hematologic, hepatic, or renal toxicity, but mild gastrointestinal side effects occurred in a majority of anemic volunteers. Carbonyl iron is an effective, inexpensive treatment for iron deficiency anemia, is accompanied by tolerable side effects and may have an advantage over therapy with iron salts by substantially reducing or eliminating the risk of iron poisoning in children.
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Gordeuk, VR, GM Brittenham, CE McLaren, MA Hughes, and LJ Keating. "Carbonyl iron therapy for iron deficiency anemia." Blood 67, no. 3 (March 1, 1986): 745–52. http://dx.doi.org/10.1182/blood.v67.3.745.bloodjournal673745.
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To determine if elemental carbonyl iron powder is safe and effective therapy for iron deficiency anemia, 20 nonanemic and 32 anemic volunteers were studied. Single doses of 1,000 to 10,000 mg of carbonyl iron (15 to 150 times the 65 mg of iron in the usual dose of ferrous sulfate) were tolerated by nonanemic volunteers with no evidence of toxicity and only minor gastrointestinal side effects. Anemic volunteers (menstruating women who had previously donated blood) were treated with several regimens providing 1,000 to 3,000 mg of carbonyl iron daily in one to three doses for 8 to 28 days. After 12 weeks anemia was corrected in 29 of 32 patients, and serum ferritin was greater than 12 micrograms/L in 14. Hemoglobin regeneration proceeded at a rate similar to that described for therapy with oral iron salts and parenteral iron dextran. There was no evidence of hematologic, hepatic, or renal toxicity, but mild gastrointestinal side effects occurred in a majority of anemic volunteers. Carbonyl iron is an effective, inexpensive treatment for iron deficiency anemia, is accompanied by tolerable side effects and may have an advantage over therapy with iron salts by substantially reducing or eliminating the risk of iron poisoning in children.
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Boutry, Mireille, and Robert Needlman. "Use of Diet History in the Screening of Iron Deficiency." Pediatrics 98, no. 6 (December 1, 1996): 1138–42. http://dx.doi.org/10.1542/peds.98.6.1138.
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Objective. To determine the relationship between diet history and microcytic anemia, a proxy for iron deficiency, and the utility of a brief dietary history in screening for microcytic anemia. Design. Cross-sectional study based on review of clinical records. Setting. Urban academic primary care clinic. Subjects. A total of 305 healthy, African-American inner-city children, presenting for well child care at 15 to 60 months of age. Children with recent minor illness or medicinal iron intake, hemoglobinopathies, chronic illnesses, failure to thrive, or elevated lead levels were excluded. Method. A brief dietary history was taken in the course of primary care visits. Dietary deficiency was defined as: (1) less than five servings each of meat, grains, vegetables, and fruit per week; (2) more than 16 oz of milk per day; or (3) daily intake of fatty snacks, sweets, or more than 16 oz of soft drink. Hematologic indices were obtained. Results. The prevalence of microcytic anemia (hemoglobin, < 11 g/dL; mean corpuscular volume, <73 fL) was 8% (24 of 305). The prevalence of low hemoglobin (<11 g/dL) with or without microcytosis was 12% (38 of 305). Dietary deficiency was associated with microcytic anemia (x2 = 26.8). As a screening test for microcytic anemia, dietary deficiency had a sensitivity of 71% (17 of 24), specificity of 79% (222 of 281), and negative predictive value of 97% (222 of 229). Conclusion. Microcytic anemia was associated with a deficient diet among low-income African-American children. A brief dietary history correctly identified children at low risk for microcytic anemia 97% of the time.
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Nazir, Fahad, Asim Khurshid, and Muhammad Abu Talib. "Intravenous iron sucrose in malnourished children with iron deficiency anemia." Professional Medical Journal 27, no. 09 (September 10, 2020): 1867–71. http://dx.doi.org/10.29309/tpmj/2020.27.09.4107.
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Objectives: To compare the mean hemoglobin level before and six weeks after giving intravenous iron sucrose therapy in malnourished children having iron deficiency anemia. Study Design: Quasi Experimental Study. Setting: Nutritional Stabilization Centre, Children Hospital and Institute of Child Health, Multan. Period: From July 2018 to December 2018. Material & Methods: A total of 80 patients were enrolled in the study. Hemoglobin level at baseline was recorded. IV iron sucrose therapy was divided into 3 equal doses and administered on 3 consecutive days. After 6 weeks of administration of iron sucrose, hemoglobin level was noted. Independent sample T-test was applied to compare Hb level before and after therapy with p-value≤0.05 as significant. Results: Overall, mean age was 13.39±6.11months. There were 54 (67.5%) males and 28 (32.5%) females. The mean weight of patients was 5.06±1.45kg and mean height was 64.59±8.72cm. The weight for height ratio was <-3SD in all patients (100%). The mean hemoglobin level of patients at baseline was 7.37±0.44g/dl, which was improved to 9.47±0.47g/dl after 6 weeks treatment. This was significant improvement (p<0.05). Conclusion: Thus intravenous iron sucrose therapy can significantly improve the condition of child and rectify the IDA.
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Weiler, Hope A., Sonia Jean-Philippe, Tamara R. Cohen, Catherine A. Vanstone, and Sherry Agellon. "Depleted iron stores and iron deficiency anemia associated with reduced ferritin and hepcidin and elevated soluble transferrin receptors in a multiethnic group of preschool-age children." Applied Physiology, Nutrition, and Metabolism 40, no. 9 (September 2015): 887–94. http://dx.doi.org/10.1139/apnm-2014-0328.
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Iron deficiency anemia is prevalent in subgroups of the Canadian population. The objective of this study was to examine iron status and anemia in preschool-age children. Healthy children (n = 430, 2–5 years old, Montreal, Quebec, Canada) were sampled from randomly selected daycares. Anthropometry, demographics, and diet were assessed. Biochemistry included hemoglobin, ferritin, soluble transferrin receptors (sTfR), ferritin index, markers of inflammation (C-reactive protein, interleukin 6 (IL-6), and tumour necrosis factor alpha (TNFα)), and hepcidin. Iron deficiency and anemia cutoffs conformed to the World Health Organization criteria. Differences among categories were tested using mixed-model ANOVA or χ2tests. Children were 3.8 ± 1.0 years of age, with a body mass index z score of 0.48 ± 0.97, and 51% were white. Adjusted intakes of iron indicated <1% were at risk for deficiency. Hemoglobin was higher in white children, whereas ferritin was higher with greater age and female sex. Inflammatory markers and hepcidin did not vary with any demographic variable. The prevalence of iron deficiency was 16.5% (95% confidence interval (CI), 13.0–20.0). Three percent (95% CI, 1.4–4.6) of children had iron deficiency anemia and 12.8% (95% CI, 9.6–16.0) had unexplained anemia. Children with iron deficiency, with and without anemia, had lower plasma ferritin and hepcidin but higher sTfR, ferritin index, and IL-6, whereas those with unexplained anemia had elevated TNFα. We conclude that iron deficiency anemia is not very common in young children in Montreal. While iron deficiency without anemia is more common than iron deficiency with anemia, the correspondingly reduced circulating hepcidin would have enabled heightened absorption of dietary iron in support of erythropoiesis.
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Graczykowska, Karolina, Joanna Kaczmarek, Dominika Wilczyńska, Ewa Łoś-Rycharska, and Aneta Krogulska. "The Consequence of Excessive Consumption of Cow’s Milk: Protein-Losing Enteropathy with Anasarca in the Course of Iron Deficiency Anemia—Case Reports and a Literature Review." Nutrients 13, no. 3 (March 3, 2021): 828. http://dx.doi.org/10.3390/nu13030828.
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Cow’s milk is a key component of a child’s diet. While the consumption of even trace amounts can result in allergy to its proteins and/or hypolactasia, excessive cow’s milk consumption can result in numerous health complications, including iron deficiency, due to the diet being improperly balanced. Although the incidence of iron deficiency has declined, it remains the most widespread nutritional deficiency globally and the most common cause of anemia. One rare consequence of anemia caused by iron deficiency is protein-losing enteropathy; however, the mechanisms of its development are unclear. The following manuscript, based on a literature review, presents two rare cases of children, a 16-month-old boy and a 2.5-year-old girl, who developed severe microcytic anemia, enteropathy with hypoalbuminemia, and anasarca as a result of excessive cow’s milk consumption. It highlights the possible relationship between excessive consumption of cow’s milk in children and severe iron deficiency anemia with accompanying hypoalbuminemia; it may also result in serious clinical conditions, even in children that do not demonstrate food hypersensitivity.
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Moningkey, Christie, Max F. J. Mantik, and Vivekenanda Pateda. "Ferric sodium edetate therapy in children with iron deficiency anemia." Paediatrica Indonesiana 55, no. 2 (April 30, 2015): 91. http://dx.doi.org/10.14238/pi55.2.2015.91-4.
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Background Iron deficiency anemia (IDA) is frequentlyfound in school-aged children. The main treatments for IDAare overcoming the causal factors and iron supplementation.Noncompliance in taking iron tablets and the possibility of ironabsorbtion or transport difficulties, can reduce efficacy of daily oraliron supplementation. Because excess iron storage in the intestinalcells can lead to mucosal blockage, twice weekly oral iron therapymay be considered instead of daily dosage.Objective To compare the effects of daily vs. twice weekly ferricsodium edetate (NaFeEDTA) on hemoglobin (Hb), hematocrit(Ht), mean corpuscular volume (MCV), mean corpuscularhemoglobin (MCH), and mean corpuscular hemoglobinconcentration (MCHC) levels on children with IDA.MethodsWe conducted an open-label, randomized, prospectivestudy in 36 children with IDA aged 5-11 years. Subjects weredivided into two groups. For a one-month period, group I receiveddaily iron therapy (NaFeEDTA) and group II received twiceweekly iron therapy. Examinations of Hb, Ht, MCV, MCH, MCHCwere performed before and after iron therapy.Results There were no significant differences in Hb, Ht, MCV,MCH or MCHC levels after therapy between the daily and twiceweekly NaFeEDTA groups (P > 0.05).Conclusion Twice weekly NaFeEDTA therapy is as effective asdaily NaFeEDTA administration in children with IDA.
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Qader, Mohammed, and Abbas Rabaty. "Impact of iron deficiency anemia on HbA1c level in non-diabetic children." Zanco Journal of Medical Sciences 25, no. 3 (December 23, 2021): 619–24. http://dx.doi.org/10.15218/zjms.2021.027.
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Background and objective: HbA1c has been endorsed by the American Diabetes Association and World Health Organization to diagnose and monitor diabetes mellitus. Its value is directly proportional to the blood glucose level. However, besides the blood glucose level, other factors like iron deficiency anemia can affect HbA1c level. We conducted this study to reveal the impact of iron deficiency anemia on HbA1c level and to assess whether HbA1c result changes after the correction of iron deficiency anemia. Methods: Twenty five non-diabetic children who were confirmed to have iron deficiency anemia were enrolled. HbA1c, hemoglobin, serum iron, and ferritin were measured and compared at baseline and post-correction of iron deficiency anemia with a three-month age-appropriate dose of iron therapy. The baseline results were compared with 25 age- and sex-matched normal controls. Results: Children with iron deficiency anemia had significantly higher HbA1c level (6.144±0.6312, P <0.001) than the control group (5.032±0.5558, P <0.001). After three months of treatment of iron deficiency anemia, HbA1c significantly dropped (from 6.144±0.6312, P <0.001 to 5.604±0.51, P <0.001). Conclusion: This study concluded that HbA1c is inversely proportional to iron deficiency anemia in non-diabetic children, and treatment of iron deficiency anemia led to a drop in HbA1c level. Due to this false elevation of HbA1c by iron deficiency anemia, iron deficiency anemia should be considered and excluded before making the diagnosis or deciding on any therapeutic change in diabetic children. Keywords: Iron deficiency anemia; HbA1c; Non-diabetic children.
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Kazi, Naheed Haroon, Roomana Qureshi, Tasneem Kousar, Ameena Saba, and Shabaz Ahmed Memon. "Factors Responsible for Iron Deficiency Anemia in Children Under Five Years." Pakistan Journal of Medical and Health Sciences 16, no. 1 (January 30, 2022): 1047–49. http://dx.doi.org/10.53350/pjmhs221611047.
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Objective: To determine the frequency of factors responsible for iron deficiency anemia in children under five years of age at tertiary care Hospital. Methodology: This cross-sectional study was done at the paediatric department of Muhammad Medical College MirpurKhas, during six months from October 2020 to March 2021. All the children with of (<5 years), presented at Paediatric OPD and of either gender were included. After taking complete clinical examination, parents were interviewed reading history of diet. After obtaining informed consent from the parents, a 3ml blood sample was taken from each case and was immediately sent to the Hospital diagnostic laboratory for the complete blood count (CBC). Anemia was defined as hemoglobin level <11g/dl. All the data was gathered via self-made study proforma and SPSS version 26 was used for the purpose of data analysis. Results: A total of 58 children with anemia were studied, their mean age was 02.91+1.29 years, mean Hb was 7.22+1.27mg/dl. Males were 56.9% and females were 40.1%. History of Buffalo milk consumption was in 53.4% children, history of pica was in 27.6%, Caffeine containing food history was in 84.5% of the cases, age of weaning <12 months was in most of the cases and non-iron containing food consumption was also commonest. Most of the cases 55.20% had moderate anemia and 43.10% had severe anemia. The severity of childhood anemia was statically significant according to the type of milk consumption, type of food and caffeine containing food (p-<0.05), while it was statistically insignificant according to the gender and age of weaning (P->0.05). Conclusion: As per study conclusion the Buffalo milk consumption, history of pica, caffeine containing food, age of weaning <12 months and non-iron containing food consumption were observed to be the commonest factors responsible for childhood anemia. Key words: Iron deficiency anemia, factors, diet
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Saragih, Rina A. C., T. Mirda Zulaicha, Sri Sofyani, Bidasari Lubis, and Iskandar Z. Lubis. "Behavior of elementary schoolchildren with iron deficiency anemia after iron therapy." Paediatrica Indonesiana 49, no. 5 (October 31, 2009): 276. http://dx.doi.org/10.14238/pi49.5.2009.276-80.
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Background Some studies had been performed to determine theassociation between iron status and children's behavior yet it isstill controversial.Objective To investigate whether iron therapy has an effect onthe behavior of children with iron deficiency anemia (IDA).Method A randomized placebo-controlled clinical trial wasconducted in Labuhan Batu on November 2006-April2007. IDAwas defined as Hb < 12 g/dl, MCHC< 31%, ROW index > 220and Mentzer index> 13. Elementary school children (6-12 yearsold) with IDA were randomly assigned to the treatment groupwith a daily therapy of 6 mg iron/kg/day or placebo group for three months. The subjects' behavior was evaluated with child behavior check list (CBCL) before and six months after intervention.Results After six months, 110 subjects completed the therapy.Scores of CBCL in iron group after intervention were internalizing42.64 (SO 9.95), externalizing 37.13 (SO 9.04) & total score 38.24 (SO 10.20). There was significant decreased on externalizing and total problems score in the treatment group after intervention (P< 0.05). However, there was no significant difference on scores between groups.Conclusion Iron therapy had significantly decrease CBCL scoreon externalizing and total problems in the treatment group,however there was no significant difference on scores if comparedwith placebo group.
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Siqueira, Maria Clara Gonçalves, Lorrayne dos Santos Bezerra, Camila Zanini Gimenes de Freitas, Simone de Cássia Casadei Buchalla, and Sabrina Alves Lenquiste. "ASSOCIAÇÃO DO ESTADO NUTRICIONAL COM MARCADORES DE ANEMIA FERROPRIVA EM PRÉ-ESCOLARES ATENDIDOS EM UMAESF DE PRESIDENTE PRUDENTE-SP." Colloquium Vitae 12, no. 1 (March 9, 2020): 8–19. http://dx.doi.org/10.5747/cv.2020.v12.n1.v278.
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Iron deficiency is the cause of 50% of anemia cases, being related to an unbalanced diet and nutrient malabsorption, affecting mainly children. The aim of the present study was to relate anthropometric measurements and markers of iron deficiency anemia in children attending a Family Health Strategy (FHS). Information was collected from medical records about breastfeeding, biochemical indicators of anemia and recent anthropometric measurements. Correlation analyzes were established between anthropometric measurements and blood count values, considering a level of statistical significance of p<0.05. The results show that 27.27% are in anemia, and only 19.69% of the 66 children had iron and ferritin tests. There was no correlation between body mass indexand hemoglobin and hematocrit results. It was concluded that the prevalence of iron deficiency anemia, identified by hemoglobin values, was low. However, there is a high occurrence of prophylactic supplementation without indication with ferrous sulfate, increasing the risk of excessive iron supplementation.
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Lyfia, Dina, Melda Deliana, Hakimi Hakimi, Nelly Rosdiana, and Bidasari Lubis. "Growth velocity in elementary school children with iron deficiency anemia after iron therapy." Paediatrica Indonesiana 49, no. 5 (October 31, 2009): 249. http://dx.doi.org/10.14238/pi49.5.2009.249-52.
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Background Iron supplementation in children with iron deficiencyanemia could decrease the incidence of stunting.Objective To study the effect of iron therapy on growth velocityin children with iron deficiency anemia.Methods A randomized clinical trial study was conducted atLabuhan Batu on November 2006 to May 2007. Iron deficiencyanemia was diagnosed if there were anemia, with mean corpuscular hemoglobin concentration <31 %, red cell distribution width index > 220, and Mentzer index> 13. Elementary school children (6-12 year old) with iron deficiency anemia were randomly assigned either to iron therapy group (children were given 6 mg iron/kg/day) or to placebo group for 3 months.Results Among 300 children recruited, there were 125 children,who suffered from iron deficiency anemia. After one month ofiron therapy, means of hemoglobin concentration were 12.4 g/dl in iron group and 11.7 g/dl in placebo group. There was a significant increase of height in iron group (129.9 (SD 7.58) em vs. 132.2 (SD 7.23) em) and in placebo (130.8 (SD 8.78) em vs. 128.7 (SD 8. 79) em), However, no significant difference was found in the mean of growth velocity between placebo and iron groups (2.1 (SD 0.01) em vs. 2.0 (SD 0.9) em.Conclusion There is a significant increase in height, but nosignificant difference between both groups in growth velocity.
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Husain, Arif, and Shrish Bhatnagar. "Does H. pylori therapy augments the effect of iron therapy among children with iron deficiency anemia?" International Journal of Contemporary Pediatrics 7, no. 4 (March 21, 2020): 831. http://dx.doi.org/10.18203/2349-3291.ijcp20201139.
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Background: To assess beneficial effects of H. pylori therapy on children with pre-existing Iron Deficiency Anemia (IDA).Methods: A total of 218 consecutive patients with iron deficiency anemia (Hb 6-11 gm/dl) were invited to participate in the study. Patients underwent endoscopic biopsy and rapid urease test for H. pylori detection. A total of three groups were formed- Group I (n=13) - positive for H. pylori, underwent treatment for H. pylori therapy and IDA, Group II (n=16) - positive for H. pylori, underwent treatment for IDA only, Group III (n=101) - negative for H. pylori, underwent treatment for IDA only. All the patients were followed up after every 4 weeks till week 12. Change in haematological parameters and anaemic and iron status was assessed. Chi-square paired ‘t’-test and ANOVA were used using SPSS 21.0.Results: All the 3 groups showed a significant increase in S. Hb, Ferritin and iron levels and a decrease in S. TIBC levels. At 12 weeks, mean S. ferritin and S. iron levels were significantly higher in Groups I and III as compared to Group II while Mean S. TIBC levels were significantly higher in Group II as compared to that in Groups I and II. A total of 73.3% of Group III, 53.8% of Group I and 56.3% of Group II patients had hemoglobin levels >11 g/dl, but difference was not significant (p=0.175).Conclusions: The findings of study showed that H. pylori therapy augments the effect of iron therapy among H. pylori positive children with iron deficiency anemia.
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Kapoh, Sabatika R., Linda W. A. Rotty, and Efata B. I. Polii. "Terapi Pemberian Besi pada Penderita Anemia Defisiensi Besi." e-CliniC 9, no. 2 (March 16, 2021): 311. http://dx.doi.org/10.35790/ecl.v9i2.32863.
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Abstract: Iron deficiency anemia (IDA) is caused by deficiency of iron needed for hemoglobin synthesis. Based on WHO data 2011, of 100% cases of patients with severe anemia, there were 50% of pregnant women, 49% of non-pregnant women, and 42% of children suffered from iron deficiency. Other literatures mentioned about 2-5% of adult men and post menopause women were diagnosed as iron deficiency anemia in developed countries. This study was aimed to determine the relationship between iron therapy in patients and iron deficiency anemia. This was a literature review study, summarizing the results of studies that included iron therapy to iron deficiency anemia patients. The results showed a positive result of iron therapy among iron deficiency anemia patients. In conclusion, there is an increase in hemoglobin among iron deficiency anemia patients after being given iron therapy.Keywords: iron deficiency anemia, iron therapy Abstrak: Anemia defisiensi besi (ADB) disebabkan oleh kekurangan zat besi yang dibutuhkan untuk sintesis hemoglobin. Berdasarkan data dari WHO (World Health Organization) tahun 2011, dari 100% kasus penderita anemia berat yang dilaporkan, diperkirakan 50% wanita hamil, 49% wanita tidak hamil, dan 42% kasus anak penderita anemia didapatkan berkaitan dengan kekurangan zat besi. Data lain menyebutkan sekitar 2-5% pria dewasa dan wanita pasca menopause mengalami ADB di negara maju. Penelitian ini bertujuan untuk mengetahui hubungan pemberian besi pada pasien anemia defisiensi besi. Jenis penelitian ialah literature review. Hasil penelitian ini menunjukkan hasil positif pemberian terapi besi pada pasien anemia defisiensi besi. Simpulan penelitian ini ialah terdapat peningkatan hemoglobin pada pasien anemia defisiensi besi setelah diberikan terapi besi.Kata kunci: anemia defisiensi besi, terapi besi
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Kucuk, Nuran, Zerrin Orbak, Cahit Karakelloglu, and Fatih Akcay. "The effect of therapy on plasma ghrelin and leptin levels, and appetite in children with iron deficiency anemia." Journal of Pediatric Endocrinology and Metabolism 32, no. 3 (March 26, 2019): 275–80. http://dx.doi.org/10.1515/jpem-2018-0352.
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Abstract Background It is known that iron deficiency anemia effects appetite and growth negatively. The aim of this study was to investigate the effect of iron therapy on appetite, growth and plasma ghrelin and leptin levels in children aged between 12 and 24 months with isolated nutritional iron deficiency anemia. Methods Iron deficiency anemia was diagnosed by clinic and laboratory findings. All 19 cases were given 5 mg/kg/day iron therapy for 3 months. Results The mean plasma ghrelin level was 936.7±428.8 pg/mL before therapy and it increased to 1284.7±533.3 pg/mL (p<0.001) while the mean plasma leptin level decreased from 3.4±1.6 ng/mL to 1.9±1.0 ng/mL (p<0.01) after therapy. The amount of daily caloric intake, carbohydrate and protein intake were significantly increased after therapy (p<0.001). Δ body weight was correlated with plasma ghrelin levels before and after therapy significantly. Conclusions In conclusion, the findings of this study indicate that plasma ghrelin level increases and leptin level decreases and growth accelerates because of an increase in appetite and daily calories, carbohydrate and protein amount in children with nutritional iron deficiency anemia after iron therapy. The increase in appetite and acceleration on growth in iron deficiency anemia might result from decreased leptin and increased plasma ghrelin levels. The most important finding of this study is significantly increased plasma ghrelin levels after iron therapy, and this finding might be related to both the improved appetite and catch-up growth.
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Akin, Mehmet, Enver Atay, Osman Oztekin, Cem Karadeniz, Yasin Tugrul Karakus, Bilal Yilmaz, and Firat Erdogan. "Responsiveness to Parenteral Iron Therapy in Children with Oral Iron-Refractory Iron-Deficiency Anemia." Pediatric Hematology and Oncology 31, no. 1 (October 2, 2013): 57–61. http://dx.doi.org/10.3109/08880018.2013.829540.
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Powers, Jacquelyn M., Margaret Nagel, Jean L. Raphael, Donald H. Mahoney, George R. Buchanan, and Deborah I. Thompson. "Barriers to and Facilitators of Iron Therapy in Children with Iron Deficiency Anemia." Journal of Pediatrics 219 (April 2020): 202–8. http://dx.doi.org/10.1016/j.jpeds.2019.12.040.
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Camaschella, Clara. "Iron deficiency." Blood 133, no. 1 (January 3, 2019): 30–39. http://dx.doi.org/10.1182/blood-2018-05-815944.
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Abstract Iron deficiency anemia affects >1.2 billions individuals worldwide, and iron deficiency in the absence of anemia is even more frequent. Total-body (absolute) iron deficiency is caused by physiologically increased iron requirements in children, adolescents, young and pregnant women, by reduced iron intake, or by pathological defective absorption or chronic blood loss. Adaptation to iron deficiency at the tissue level is controlled by iron regulatory proteins to increase iron uptake and retention; at the systemic level, suppression of the iron hormone hepcidin increases iron release to plasma by absorptive enterocytes and recycling macrophages. The diagnosis of absolute iron deficiency is easy unless the condition is masked by inflammatory conditions. All cases of iron deficiency should be assessed for treatment and underlying cause. Special attention is needed in areas endemic for malaria and other infections to avoid worsening of infection by iron treatment. Ongoing efforts aim at optimizing iron salts–based therapy by protocols of administration based on the physiology of hepcidin control and reducing the common adverse effects of oral iron. IV iron, especially last-generation compounds administered at high doses in single infusions, is becoming an effective alternative in an increasing number of conditions because of a more rapid and persistent hematological response and acceptable safety profile. Risks/benefits of the different treatments should be weighed in a personalized therapeutic approach to iron deficiency.
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Korol, T. G., K. V. Khromykh, H. M. Rudenko, and A. V. Bereznitskiy. "Scientific reviews. Principles of diagnosis and treatment of iron deficiency anemia in children." Reports of Vinnytsia National Medical University 25, no. 3 (September 23, 2021): 510–13. http://dx.doi.org/10.31393/reports-vnmedical-2021-25(3)-28.
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Annotation.In Europe, the overall prevalence of iron deficiency anemia is 2-4%, with two peaks: young children (2.3-15%) and adolescents (3.5-13% – in boys, 11-33% – in girls). Iron deficiency occurs earlier than anemia, which is characterized by a decrease in the size and iron saturation of erythrocytes, and they become microcytic and hypochromic. Therefore, anemia can be prevented by early diagnosis and treatment of latent iron deficiency. The aim of the work was to analyze and systematize the main problematic issues of diagnosis and treatment of iron deficiency anemia in children. To conduct the study, we analyzed databases PubMed, Cochrane Library, Google Scholar, etc., referring to the vast majority of publications from the last five years (2016-2021), in addition to three articles published in 2012 and 2014. The main criteria for selecting sources were: the availability of the latest methods for the diagnosis of anemia, modern methods of treatment of iron deficiency anemia in children. Analysis of the identified literature sources showed that iron deficiency in the laboratory and clinically can manifest itself at different stages. Negative iron balance, which persists after a decrease in iron stores, is manifested by a decrease in hemoglobin and the development of anemia. A decrease in the number of erythrocytes or the level of hemoglobin (Hb) by 5 percentile below the normal value of hemoglobin, determined for a given age in healthy people, is called anemia. Routine screening for iron deficiency should be performed in children aged 6 to 24 months. Screening consists of identifying risk factors and laboratory testing if available. Determination of serum ferritin during the first screening is the main diagnostic tool in children with risk factors for iron deficiency and signs of anemia. Ferritin levels should always be carefully evaluated, as ferritin is nonspecifically elevated in a variety of inflammatory conditions. Other screening tests, such as reticulocyte levels, iron transferrin saturation, and serum iron-binding capacity, are performed to confirm the diagnosis. The choice and route of administration of iron requires consideration of the cause that led to its deficiency, the severity of symptoms and condition of the patient, the probable and desired rate of hematological response, risks and complications of treatment, availability of resources and preferences of the patient. Oral iron remains a priority for the treatment of children with iron deficiency anemia, but it is necessary to consider situations where first-line therapy will be administered by intravenous means. Thus, based on the analysis of the literature, we can conclude that iron deficiency anemia remains an urgent medical and social problem today. Children with iron deficiency anemia develop cognitive impairment that does not fully recover even after treatment. Therefore, further research aimed at improving methods of prevention, early diagnosis and treatment of iron deficiency anemia in different age groups of children should be promising.
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Tiwari, Bharti, Amar Singh Tiwari, and Satish Chand Gupta. "AN AMELIORATE COMPARATIVE CLINICAL TRIAL OF NAVAYAS LOUHA SYRUP AND NISHA LOUHA SYRUP IN THE MANAGEMENT OF PANDU ROGA WITH SPECIAL REFERENCE TO IRON DEFICIENCY ANEMIA IN CHILDREN." International Journal of Research in Ayurveda and Pharmacy 12, no. 4 (August 28, 2021): 56–61. http://dx.doi.org/10.7897/2277-4343.1204106.
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Anemia is a major health problem in India. Yet, a comprehensive plan of action to combat this public health problem has been still missing. There are few existing plans for the control of Iron Deficiency Anemia regarding children and pregnant women and lactating mothers. Iron deficiency is the result of long-term negative iron balance. Iron deficiency anemia (IDA) should be regarded as a subset of iron deficiency, that is, it represents the extreme lower end of the distribution of iron deficiency. Treatment options include oral and intravenous iron therapy; however, the efficacy of oral iron is limited in certain gastrointestinal conditions, such as inflammatory bowel disease, celiac disease, and autoimmune gastritis. So that ameliorate comparative clinical trial was taken with Ayurveda formulation for the diagnosis and treatment of iron deficiency anemia (IDA) with special reference to Pandu Roga. Overall, in the study Navayas Louha was found to have 76.53% and of Nisha Louha was found to have 69.33% clinical efficacy. The study showed that trial clinical efficacy of Navayas Louha syrup is better than Nisha Louha syrup in the management of iron deficiency anemia in Indian children.
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YILMAZ, Resul, and Yasemin Asan. "The effect of iron replacement therapy on appetite in children with iron deficiency anemia." Journal of Contemporary Medicine 9, no. 2 (May 1, 2019): 1. http://dx.doi.org/10.16899/jcm.559567.
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Tiwari, Bharti, Amar Singh Tiwari, and Satish Chand Gupta. "A COMPARATIVE RANDOMIZED CLINICAL TRIAL OF NAVAYAS LOUHA SYRUP AND NISHA LOUHA SYRUP IN THE MANAGEMENT OF IRON DEFICIENCY ANEMIA IN INDIAN CHILDREN WITH SPECIAL REFERENCE TO PANDU ROGA." International Journal of Research in Ayurveda and Pharmacy 11, no. 6 (December 30, 2020): 16–21. http://dx.doi.org/10.7897/2277-4343.1106178.
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Iron deficiency is the most usual dietary deficiency worldwide, approximately 25% of the world’s population suffering from iron deficiency anemia according to the World Health Organization. A Neonate has total body iron of 250 mg (80 mg/kg), obtained from maternal sources. In the first 6 months of life, during the period when the infant gets an iron-deficient milk diet, this amount decreases to 60 mg/kg. Infants fed with cow’s milk are at greater risk to develop iron deficiency anemia because calcium from cow’s milk is competing with iron for absorption. There are a large number of formulations (like Navayas Louha Syrup, Nisha Louha Syrup etc.) that are mentioned to prevent iron deficiency anemia in Indian children. Despite lack of scientific data regarding the clinical efficacy of Navayas Louha Syrup and Nisha Louha Syrup, an effort has been done to present the current scenario. 60 anemic patients of either sex age between 1-15 years were randomly selected from Kaumarabhritya O.P.D. and I.P.D. of Rani Dullaiya Post Graduate Ayurvedic College and Hospital, Bhopal (M.P), India. Overall, in the study Navayas Louha is 74.53% and Nisha Louha is 69.34% having clinical efficacy. The study was showed in clinical trial efficacy of Navayas Louha syrup is better than Nisha Louha syrup in the management of iron deficiency anemia in Indian children.
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Markova, E. A., A. Z. Khashukoeva, S. A. Khlynova, M. V. Burdenko, and A. Kh Karanasheva. "Anemia in elderly women. Rational prevention. Evidence base." Meditsinskiy sovet = Medical Council, no. 3 (April 15, 2021): 128–34. http://dx.doi.org/10.21518/2079-701x-2021-3-128-134.
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Iron deficiency anemia is a frequent companion in postmenopausal women and those who have reached adulthood. Anemia in mild form in elderly women often occurs almost asymptomatically. Over time, iron deficiency progresses: severe complications occur, the quality of life decreases significantly, and the prognosis for life becomes unfavorable. A cross-section of the literature data in recent years shows that iron, folate, vitamin B12 deficiency, gastrointestinal diseases, pathologies in the processes of erythropoiesis and other somatic diseases come to the fore in terms of the etiological factors of anemia in elderly women. An important role in the development of anemia in older women is played by an irrational diet throughout life, which causes a lack of iron and folate in food. That is why therapy with a complex drug, which includes iron (II) fumarate in combination with folic acid is a rational choice in comparison with iron monotherapy for the prevention and treatment of anemia in elderly women. The administration of oral iron preparations for the correction of iron deficiency and for the purpose of selecting an effective pathogenetic therapy for anemia solves the problem of complications and improves the quality of life of older women. Iron (II) fumarate + folic acid - a tablet form of iron preparation in combination with folic acid for oral use, which has good tolerability, quickly replenishes iron reserves in the body of elderly patients, reducing mortality in this age group.
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Solomon, P. John, Margaret Chellaraj, and A. Priya Margaret. "Anemia in Indian Children and Management." Scholars Journal of Applied Medical Sciences 9, no. 7 (July 17, 2021): 1185–91. http://dx.doi.org/10.36347/sjams.2021.v09i07.012.
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Anemia is defined as hemoglobin level of less than the 5th percentile for age [1]. It is a common condition in children seen in everyday practice. It has to be detected early to prevent complications. Anemia is more common in children below 2 years of age. Most children with mild anemia are asymptomatic. Hence, in many countries where the prevalence of anemia is very high it is common practice to screen for anemia at 1 year of age. Most cases of anemia in our country are caused by nutritional deficiency of iron, and or vitamins. Simple investigations and treatment are adequate to diagnose and manage most of the cases of anemia. Medical practitioners should have a thorough knowledge about the common causes of anemia and their management. Referral to a Pediatric Hematologist is required only in some cases. Before arriving at a conclusion we should compare the blood results with normal values for that age. Anemia in the newborn may be due to blood loss, hemolysis caused by blood group incompatibilities or abnormalities of the cell membranes of the RBCs or its enzymes. During infancy and childhood the commonest cause of Anemia is nutritional, of which iron deficiency is more common. Folic acid and B12 deficiency can also cause anemia. Thalassemia major and severe forms of hereditary spherocytosis cause anemia and jaundice requiring blood transfusion and iron chelation and folic acid therapy. Autoimmune hemolytic anemia is not common in children. In some inherited diseases like Thalassemia Hematopoietic Stem Cell Transplantation offers the best hope for cure.
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Gunadi, Dedy, Nelly Rosdiana, and Bidasari Lubis. "Comparison of once a day and three times a day iron treatment in 9 ... 12 year old elementary school children with iron deficiency anemia." Paediatrica Indonesiana 49, no. 2 (April 30, 2009): 104. http://dx.doi.org/10.14238/pi49.2.2009.104-7.
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Background The compliance of iron deficiency anemia treatmentthat is administered three times daily in children is low. Thecompliance will be better if therapy is administered once daily.Objective To compare the iron therapy response of once per dayvs. three times a day administration in 9-12 year old children withiron deficiency anemia.Methods Children with iron deficiency anemia were randomlyallocated into a ferrous sulfate once-daily group or a ferrous sulfatethree times-daily group with the same dose of 5 mg/kg /day ofelemental iron for 30 days. Iron deficiency anemia was definedas Hb < 12 g/dL (World Health Organization criteria), MCV< 70 fl, RDW > 16 %, Mentzer index > 13 and RDW index >220. Iron treatment response was characterized by the increase inHb level 30 days after treatment. Peripheral blood samples werecollected at the start and end of the study.Results Ninety seven children were enrolled. There weresignificant increases in Hb levels in both groups after 30 days ofiron therapy, but there was no significant difference in Hb levelbetween the two groups (P=0.55).Conclusion The administration of a once daily dose of ferroussulfate did not show a significant difference in the increase ofHblevels compared to a three times daily dose.
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Pshenichnaya, Ksenia I., and Tatyana N. Kasatkina. "The efficacy of treatment of early stage of iron-deficiency states in children." Pediatrician (St. Petersburg) 7, no. 4 (December 15, 2016): 128–31. http://dx.doi.org/10.17816/ped74128-131.
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The deficiency of iron is one of the most widespread deficits. This deficiency is most common in the growing organism. There is a large quantity of oral therapies to correct deficit of iron. Usage of any of them can cause adverse side effects. In each and every case the pediatrician should have options to choose most optimal course of treatment of the iron deficiency state, including latent iron deficiency as iron deficiency anemia prophylaxis. The article represents data of using medical food complex “Sideral” in treatment of outpatient children. The drug was used on 44 children in age between 6 months and 3 years, who were observed in city’s out-patient hospitals. All of the children had abnormalities in clinical blood analysis, which are specific for mild iron deficiency anemia or latent iron deficiency. The treatment results were evaluated by clinical blood analysis. The positive dynamics was observed in 42 of 44 children. In a month after the treatment start, a tendency to hemoglobin, MCV and MCH levels normalization was detected, the complete normalization occurred in two months. The length of medical food comples “Sideral” usage was similar to such, recommended length of other drugs usage, and was equal to 2 months, while using in latent iron deficiency conditions, and equal to 3 month in mild iron deficiency anemia conditions. The conclusion was made that using this medical food is viable in therapy of children with mild forms of iron-deficiency.
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Martín-Masot, Nestares, Diaz-Castro, López-Aliaga, Alférez, Moreno-Fernandez, and Maldonado. "Multifactorial Etiology of Anemia in Celiac Disease and Effect of Gluten-Free Diet: A Comprehensive Review." Nutrients 11, no. 11 (October 23, 2019): 2557. http://dx.doi.org/10.3390/nu11112557.
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Celiac disease (CD) is a multisystemic disorder with different clinical expressions, from malabsorption with diarrhea, anemia, and nutritional compromise to extraintestinal manifestations. Anemia might be the only clinical expression of the disease, and iron deficiency anemia is considered one of the most frequent extraintestinal clinical manifestations of CD. Therefore, CD should be suspected in the presence of anemia without a known etiology. Assessment of tissue anti-transglutaminase and anti-endomysial antibodies are indicated in these cases and, if positive, digestive endoscopy and intestinal biopsy should be performed. Anemia in CD has a multifactorial pathogenesis and, although it is frequently a consequence of iron deficiency, it can be caused by deficiencies of folate or vitamin B12, or by blood loss or by its association with inflammatory bowel disease (IBD) or other associated diseases. The association between CD and IBD should be considered during anemia treatment in patients with IBD, because the similarity of symptoms could delay the diagnosis. Vitamin B12 deficiency is common in CD and may be responsible for anemia and peripheral myeloneuropathy. Folate deficiency is a well-known cause of anemia in adults, but there is little information in children with CD; it is still unknown if anemia is a symptom of the most typical CD in adult patients either by predisposition due to the fact of age or because biochemical and clinical manifestations take longer to appear.
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Shah, Archana N., Jaini S. Kothari, Dhara P. Desai, Tushar Savaliya, and Rajal B. Prajapati. "Clinical and biochemical outcome in pediatric patients with iron deficiency anemia." International Journal of Contemporary Pediatrics 7, no. 11 (October 21, 2020): 2146. http://dx.doi.org/10.18203/2349-3291.ijcp20204413.
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Background: Iron deficiency is a global public health problem with unique cultural, dietary and infectious hurdles that are difficult to overcome. Aims and objectives were to study clinical and biochemical profile of iron deficiency anemia, risk factors for iron deficiency anemia, presenting illnesses associated with iron deficiency anemia, association of other nutritional deficiency with iron deficiency anemia, treatment of iron deficiency anemia and recovery rate.Methods: This cross-sectional prospective study is conducted between June 2017 to May 2019in a tertiary care institute Gujarat state of India. All the children in the age group of 6 months to 5 years admitted in paediatric ward with anaemia were included in study. Data collection was done using a pretested questionnaire including socio-demographic factors. Data was analysed using statistical package for social sciences and excel and p<0.05 was considered as statistically significant.Results: The prevalence of anemia is 62.31% in patients admitted during study period. Mild to moderate anemia is observed in 75% patients. In present study, 62% patients are in age group of 6 months to 2 years and 38% patients are >2 years to 5 years. Patients with dimorphic anemia have initial mean serum B12 level 31.36 ng/ml, which improved after treatment to 312.98 ng/ml falling in the range of normalcy.Conclusion: Though anemia is common, most patients are stable and present with mild to moderate anemia. Only a fraction of patients presenting with congestive cardiac failure require packed red blood cells transfusion. Oral iron therapy for three months is the mainstay of treatment for iron deficiency anemia. Vitamin B12 therapy is also needed in patients with dimorphic anemia.
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Moscheo, Carla, Maria Licciardello, Piera Samperi, Milena La Spina, Andrea Di Cataldo, and Giovanna Russo. "New Insights into Iron Deficiency Anemia in Children: A Practical Review." Metabolites 12, no. 4 (March 25, 2022): 289. http://dx.doi.org/10.3390/metabo12040289.
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Iron deficiency anemia (IDA) is the most frequent hematological disorder in children, with an incidence in industrialized countries of 20.1% between 0 and 4 years of age and 5.9% between 5 and 14 years (39 and 48.1% in developing countries). Although IDA has been recognized for a long time, there are still uncovered issues and room for improving the management of this condition. New frontiers regarding its diagnosis and therapeutic options emerge every day; recently, innovative formulations of iron have been launched, both for oral and parenteral administration, with the aim of offering treatment schedules with higher efficacy and lower toxicity. As a matter of fact, glycinate and liposomal preparations, while maintaining a satisfying efficacy profile, have significantly fewer side effects, in comparison to the traditional elemental iron salts; parenteral iron, usually considered a second-choice therapy reserved to selected cases, may evolve further, as a consequence of the production of molecules with an interesting clinical profile such as ferrocarboxymaltose, which is already available for adolescents aged >14 years. The present article reports the clinically relevant latest insights regarding IDA in children and offers a practical guide to help pediatricians, particularly to choose the most appropriate prevention and therapy strategies.
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Casertano, Marianna, Nicoletta Di Maio, Angela Maria Caprio, Maddalena Casale, Sofia MR Matarese, and Silverio Perrotta. "Quando la carenza di ferro diventa rara…" QUADERNI ACP 28, no. 5 (2021): 254. http://dx.doi.org/10.53141/qacp.2021.254-255.
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Iron deficiency anemia is the most common nutritional disorder in the world, the most widespread form of anemia and the most frequent in children. In the presence of microcytic anemia, evidence of an iron deficiency (transferrin saturation index <10% and ferritin <12 mg/l) allows the diagnosis. An increase in requests and a reduced income are the most common causes in early childhood and adolescence. It is essential to ensure that the disorder is corrected at the end of therapy, in order to exclude rarer causes of iron deficiency. A correct diagnosisi and therapy are also essential to guarantee patients so to spare additional costs and stress for the whole family.
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Hassan, Nabil E. "Reply: Intravenous Ferumoxytol in Pediatric Patients With Iron-Deficiency Anemia." Annals of Pharmacotherapy 51, no. 12 (August 23, 2017): 1146. http://dx.doi.org/10.1177/1060028017726796.
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Iron Deficiency in children is common problem. Its mechanism could be nutritional or due to lack of iron absorption. Several conditions are associated with IDA. Presence of inflammation further complicate attempts to make a definitive diagnoses or accurately quantify reponse to therapy.
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Bhadauria, Arti, Albha Tiwari, Beenu Singh Chauhan, and Poornima Shah. "Correlation between nutritional status parameters and hemoglobin level of teenage girls and hemoglobin level." INTERNATIONAL JOURNAL OF AGRICULTURAL SCIENCES 18, no. 2 (June 15, 2022): 827–31. http://dx.doi.org/10.15740/has/ijas/18.2/827-831.
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Malnutrition is caused by the absence of any essential nutritional factor in the diet, including defects in the formation of hemoglobin or low absorption of essential nutrients. Some malnutrition due to lack of iron in the diet or high quality protein, vitamin B6 deficiency which affects the heme protein in the synthesis of hemoglobin, vitamin E deficiency which affects the stability of the membranes of red blood cells it happens. Copper is not part of the hemoglobin molecule but it affects the absorption of iron in the liver. Iron deficiency is the most common nutritional disorder in the world. Worldwide, anemia is estimated to affect 2 billion people, or 30 per cent of the world’s population and is more severe in developing countries due to frequent malaria and insect infestation. It particularly affects women in the reproductive age group and young children in tropical and sub-tropical regions. The World Bank estimates that malnutrition is a direct contributor to global diseases. Malnutrition occurs at all stages of life, but is most common in pregnant women, young children and teenage girls. Iron deficiency and malnutrition are a major public health problem among teenagers. Studies indicate that anemia in teenagers increases with age and the rate of growth is highest during teenage.
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Chesti, Mohmad Saleem, Shilakha Chaman, and Mudasir Nazir. "Role of iron in breath holding spells and effect of iron therapy in children." International Journal of Contemporary Pediatrics 8, no. 11 (October 25, 2021): 1861. http://dx.doi.org/10.18203/2349-3291.ijcp20214160.
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Background: Breath holding spells (BHS) are paroxysmal events resulting from painful stimulus or emotional event resulting in forceful crying, occur in children’s aged between 6 months to 6 years. To assess the role of iron in breath holding spells (BHS) and to assess the efficiency of iron therapy in reducing frequency of BHS.Methods: This was a prospective, interventional study conducted at GMC baramulla. A total of 70 patients between the ages of 6 months and 5 years with breath holding spells with iron deficiency and iron deficiency anemia were studied. After giving them iron therapy for 6 and 12 weeks, they were assessed for the improvement in their anemia and its impact on the frequency of breath holding spells.Results: Seventy children with breath holding spells were studied prospectively. Forty (57.15%) cases were males and 30 (42.85%) females. There was a statistically significant rise in the hemoglobin level, serum ferritin, serum iron with 6 and12 weeks of iron therapy (p<0.001). This rise in the hemoglobin level serum ferritin and serum iron was associated with a statistically significant fall in the frequency of breath holding spells with 6 and 12 weeks of iron therapy (p<0.001).Conclusions: iron supplement is effective in reducing the frequency of breath holding spells and thus iron has role in BHS.
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MANTADAKIS, ELPIS. "IRON DEFICIENCY ANEMIA IN CHILDREN RESIDING IN HIGH AND LOW-INCOME COUNTRIES: RISK FACTORS, PREVENTION, DIAGNOSIS AND THERAPY." Mediterranean Journal of Hematology and Infectious Diseases 12, no. 1 (June 28, 2020): e2020041. http://dx.doi.org/10.4084/mjhid.2020.041.
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Iron deficiency and iron deficiency anemia (IDA) affect approximately two billion people worldwide and most of them reside in low- and middle-income countries. In these countries, additional causes of anemia include parasitic infections like malaria, other nutritional deficiencies, chronic diseases, hemoglobinopathies and lead poisoning. Maternal anemia in resource-poor nations is associated with low birth weight, increased perinatal mortality and decreased work productivity. Maintaining a normal iron balance in these settings is challenging, as iron-rich foods with good bioavailability are of animal origin that are expensive and/or available in short supply. Apart from infrequent consumption of meat, inadequate vitamin C intake and diets rich in inhibitors of iron absorption are additional important risk factors for IDA in low-income countries. In-home iron fortification of complementary foods with micronutrient powders has been shown to effectively reduce the risk of iron deficiency and IDA in infants and young children in developing countries but is associated with unfavorable changes in gut flora and induction of intestinal inflammation that may lead to diarrhea and hospitalization. In developed countries, iron deficiency is the only frequent micronutrient deficiency. In the industrialized world, IDA is more common in infants beyond the sixth month of life, in adolescent females with heavy menstrual bleeding, in women of childbearing age and elderly people. Other special at-risk populations for IDA in developed countries are regular blood donors, endurance athletes and vegetarians. Several medicinal ferrous or ferric oral iron products exist, and their use is not apparently associated with harmful effects on the overall incidence of infectious illnesses in sideropenic and/or anemic subjects. Further research is needed to clarify the risks and benefits of supplemental iron for children exposed to parasitic infections in the third world, and for children genetically predisposed to iron overload.
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Balashova, E. A., L. I. Mazur, Yu V. Tezikov, and I. S. Lipatov. "The impact of iron deficiency correction in pregnant women on the perinatal period and children’s health status." Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 65, no. 1 (March 6, 2020): 51–58. http://dx.doi.org/10.21508/1027-4065-2020-65-1-51-58.
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Purpose. To identify the effects of gestational iron deficiency anemia after treatment with iron-containing drugs during the perinatal period on the health status of full-term children during their 1st year of life.Patients and methods.The authors carried out a prospective observational cohort study of full-term infants of I & II health group from their birth to twelve months. The course of pregnancy and labor was analyzed retrospectively. Hemoglobin, serum ferritin and C-reactive protein were measured in the six and twelve months old children and their mothers in 6 months after giving birth. We examined 140 couples of mother-child with gestational anemia (Group 1) and 166 couples without anemia during pregnancy (Group 2) in 6 months after giving birth, and in 12 months – 103 and 131 couples respectively. All women with iron deficiency anemia (Group 1) received therapy during pregnancy. Results. Gestational anemia is associated with threatened miscarriage (Odds Ratio (OR) 3.496; 95% CI 2.013–6.072), chronic placental insufficiency (OR 1.907; 95% CI 1.025–3.548), delivery by cesarean section (OR 2.729; 95% CI 1.651–4.502), increased infectious morbidity in pregnant women (OR 1.079; 95% CI 1.025–3.548) and insufficient lactation (OR 1.990; 95% CI 1.209– 3.277). Treated anemia during pregnancy is not associated with low birth weight and low weight of 6 and 12 months old children. 8.6% of 6 months old children suffered from iron deficiency anemia, which is two times lower than in the group without anemia (p=0.007). The frequency of iron deficiency anemia did not differ in 12 months old children (р=0.543). Conclusion: Iron supplementation reduces the negative impact of anemia on child’s health, including anthropometric indicators, iron stores, and risk of infectious diseases. The indirect effect is maintained through the adverse course of the perinatal period and the low duration of lactation.
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Rungngu, Susanti Lisupindan Palimbong, Audrey Wahani, and Max F. J. Mantik. "Reticulocyte hemoglobin equivalent for diagnosing iron deficiency anemia in children." Paediatrica Indonesiana 56, no. 2 (July 19, 2016): 90. http://dx.doi.org/10.14238/pi56.2.2016.90-4.
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Background The prevalence of iron deficiency anemia (IDA) remains high in Indonesian children. When anemia is detected in a patient, the physician’s task is to identify the cause, address it, provide iron therapy, and prevent recurrence. However, prevention is best done by early detection. The reticulocyte hemoglobin equivalent (Ret-He) is a direct measurement of iron level in reticulocytes recently produced in the bone marrow. The Ret-He measurement may be an early indicator of iron deficiency, as it is sensitive at the initial stage of the condition.Objective To assess for a relationship between Ret-He and IDA as well as to evaluate the usefulness of Ret-He for diagnosing IDA in children.Methods This analytic, observational study with cross-sectional approach included 50 children aged 6-12 years and was performed from November 2013 to March 2014. The subjects were divided into IDA or non-IDA groups, based on ferritin levels. A correlation analysis using logistic regression was performed and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and odds ratio (OR) were calculated. Results were considered to be statistically significant for P values <0.05.Results A low Ret-He level was significantly associated with IDA in children (P=0.005). The Ret-He cut-off point of 27.8 pg/L had sensitivity of 43.8%, specificity 85.3%, PPV 58.3%, and NPV 76.3%, with OR 4.5 (95%CI 1.1 to 17.7).Conclusion We find a significant positive relationship between Haemoglobin (Hb) and Ret-He in children, A low level of Ret-He is associated with greater risk of IDA in children. The Ret-He has a high specificity. As such, Ret-He may be useful as a screening tool for early detection of IDA in children.