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Severe iron deficiency anemia in 42 pediatric patients
Claudio Sandoval1, Emily Berger, M Fevzi Ozkaynak
1Department of Pediatrics, New York Medical College, Valhalla 10595, USA. claudio_sandoval@nymc.edu
Insights
Severe iron deficiency anemia in children primarily impacts those aged 13-24 months, often linked to cow's milk consumption. While oral iron suffices for many, severe cases may necessitate blood transfusions.
Area of Science:
- Pediatrics
- Hematology
- Nutritional Science
Background:
- Iron deficiency anemia (IDA) is a prevalent nutritional deficiency globally.
- Severe IDA in pediatric populations presents unique clinical challenges.
- Understanding the specific features of severe IDA is crucial for timely intervention.
Purpose of the Study:
- To define the clinical and laboratory characteristics of severe iron deficiency anemia in children.
- To identify risk factors and common presentations of severe IDA in pediatric patients.
Main Methods:
- Retrospective chart review of 198 children diagnosed with iron deficiency anemia.
- In-depth evaluation of 42 children identified with severe iron deficiency anemia.
- Analysis of demographic, dietary, clinical, and laboratory data.
Main Results:
- Severe IDA predominantly affected children aged 13-24 months (27/42).
- Cow's milk was the primary caloric source in a majority of cases (35/42).
- Median hemoglobin was 4.6 g/dL and median serum ferritin was 5 microg/L; 13 children required packed red blood cell transfusions due to cardiorespiratory distress.
Conclusions:
- Severe iron deficiency anemia in children is most common during the second year of life.
- Dietary factors, such as high cow's milk intake, are associated with severe IDA.
- While oral iron therapy is effective for most, transfusions are vital for critically ill children.
Abstract:
The objective of this study was to determine the clinical and laboratory features of children with severe iron deficiency anemia. The authors retrospectively reviewed the charts of 198 children with iron deficiency anemia to ascertain cases of severe iron deficiency anemia. Forty-two children with severe iron deficient anemia were evaluated. The median age was 21 months (range, 7-240 months) at diagnosis and 27 children were 13-24 months of age. For 35 children the major source of calories was derived from cow's milk. The median hemoglobin was 4.6 g/dL (range, 2.1-6 g/dL) and the median serum ferritin was 5 microg/L (range, 1-11 microg/L). Twenty-nine received oral iron and 13 required parked red blood cell transfusions because of co-morbid cardiorespiratory distress. Severe iron deficiency anemia mostly affects children during their second year of life. Oral iron therapy is sufficient for most children, but packed red blood cell transfusions may be needed.