Efficacy and safety of intravenous iron sucrose treatment in children with iron deficiency anemia Iron Sucrose Treatment in Children with iron deficiency anemia

Main Article Content

Elif Güler Kazancı
Muhammet Furkan Korkmaz
Betül Orhaner

Abstract

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.

Downloads

Download data is not yet available.

Article Details

How to Cite
Kazancı, E. G., Korkmaz, M. F., & Orhaner, B. (2019). Efficacy and safety of intravenous iron sucrose treatment in children with iron deficiency anemia: Iron Sucrose Treatment in Children with iron deficiency anemia. Medical Science and Discovery, 6(10), 278–283. https://doi.org/10.36472/msd.v6i10.317
Section
Research Article
Received 2019-10-04
Accepted 2019-10-27
Published 2019-10-27

References

World Health Organization. Iron deficiency anaemia assessment, prevention, and control. A guide for programme managers. Geneva (Switzerland): World Health Organization; 2001.

Siegel E.H, Stoltzfus R.J, Khatry S.K. Epidemiology of anemia among 4-to 17-month-old children living in South Central Nepal. Europian Journal of Clinical Nutrition 2006; 60: 228–35.

Schneider J.M, Fujii M.L, Lamp C.L. Anemia, iron deficiency, and iron deficiency anemia in 12–36 months -old children from low-income families. Journal of Clinical Nutrition 2005; 82: 1269–75.

Çetin E. To investigate the prevalence of anemia in children and adolescents living in Istanbul [Thesis]. Istanbul: University School of Medicine; 1997.

Gökçay G, Kılıç A. Epidemiology of iron deficiency anemia in children. Journal of Child Health and Diseases 2000; 43: 3-13.

Evliyaoglu N, Altintas D, Atici A. The iron status of breast milk, cow's milk and formula foods. Turkey Clinical J Pediatr 1996; 5: 249-59.

Gür E, Yıldız I, Celkan T. Prevalence of anemia and the risk factors among school children in İstanbul. J Trop Pediatr 2005; 51: 346-50.

Özdemir N. Iron deficiency anemia from diagnosis to treatment in children. Turk Arch Ped 2015; 50: 11-9.

Karakas Z, Karaman S. Approach to anemic child. Turkey's National Pediatric Association, Turkish Association of Pediatric Hematology, Partner Guide. Diagnostic and treatment guidelines in pediatric health and diseases. November; 2014.

Sillis R. Iron-Deficiency Anemia. In: Kliegman R, Stanton B, St Geme J, Schor N (Edt). Nelson Textbook of Pediatrics. 20th ed. Canada. Elsevier 2016; 2323-6.

Lerner N.B. Anemia In: Kliegman M.R, Stanton F.B, Schor F.N, et al, Akçay T. (Edt). Nelson Pediatri. İstanbul. Nobel Tıp Kitapevleri 2015; 1648-83.

Mantadakis E, Tsouvala E, Xanthopoulou V, et al. Intavenous iron sucrose for children with iron deficiency anemia: a single institution study. World Journal of Pediatrics 2016; 12(1): 109-13.

Celkan T, Apak H, Özkan A, et al. Prevention and Treatment in Iron Deficiency Anemia. Turk Arch Ped 2000; 35(4): 226-31.

Kılıçaslan Ö, Yıldırmak Yıldız Z, Urgancı N. The evaluation of the iron deficiency cases who were hospitalized in a pediatric clinic for deep anemia. The Medical Bulletin of Sisli Etfal Hospital 2014; (3): 234-8.

Crary E.S, Hall K, Buchanan G.R. Intravenous iron sucrose for children with iron deficiency failing to respond to oral iron therapy. Pediatric Blood Cancer 2011; 56:615-9.

Pinsk V, Levy J, Moser A, et al. Efficacy and safety of intravenous iron sucrose therapy in a group of children with iron deficiency anemia. Israel Medical Association Journal 2008; 10: 335-8.

Papadopoulos M, Patel D, Korologou-Linden R, et al. Safety and efficacy of parenteral iron in children with inflammatory bowel disease. Br J Clin Pharmacol 2018; 84: 694–9.

Ganz T, Nemeth E. Iron sequestration and anemia of inflammation. Semin Hematol 2009; 46: 387–93.

Macdougall IC. Evolution of iv iron compounds over the last century. J Ren Care 2009; 35 (Suppl 2): 8–13.

Auerbach M, Ballard H. Clinical use of intravenous iron administration efficacy and safety. Hematology Am Soc Hematol Educ Program 2010; 2010: 338–47.

Cançado RD, Muñoz M. Intravenous iron therapy: how far have we come? Rev Bras Hematol Hemoter 2011; 33: 461–9.

Fishbane S, Ungureanu VD, Maesaka JK, et al. The safety of intravenous iron dextran in hemodialysis patients. Am J Kidney Dis 1996; 28: 529–34.

Faich G, Strobos J. Sodium ferric gluconate complex in sucrose: safer intravenous iron therapy than iron dextrans. Am J Kidney Dis 1999; 33: 464–70.

Chertow GM, Mason PD, Vaage-Nilsen O, et al. Update on adverse drug events associated with parenteral iron. Nephrol Dial Transplant 2006; 21: 378–82.

Barton JC, Barton EH, Bertoli LF, et al. Intravenous iron dextran therapy in patients with iron deficiency and normal renal function who failed to respond to or did not tolerate oral iron supplementation. Am J Med 2000; 109: 27-32.