[Iron supplementation in a child with severe burns]

J A Belmonte Torras1, J Tusell Puigbert, A Piera Carreras

  • 1Servicio de Cuidados Intensivos Pediátricos y de Cirugía Pediátrica, Hospital Materno-Infantil Vall d'Hebron, Barcelona, Spain.

Insights

Severe pediatric burns can lead to functional iron deficiency, requiring supplementation. Early iron treatment in children with severe burns aids hematologic recovery and normalizes parameters.

Area of Science:

  • Pediatric Burn Management
  • Pediatric Hematology
  • Nutritional Support in Pediatrics

Background:

  • Non-intentional burns are a significant cause of childhood morbidity.
  • Severe burns (affecting >10% body surface area) in children may necessitate iron supplementation during recovery.
  • Pediatric burn patients often face complex nutritional challenges.

Observation:

  • A 15-month-old boy with severe burns (20% body surface area) and polytrauma required a dermal graft and packed red blood cell transfusion.
  • Post-burn, the child exhibited low hemoglobin and reduced reticulocyte hemoglobin content, alongside elevated mean corpuscular volume, indicating functional iron deficiency despite high ferritin levels.
  • These hematologic findings suggested a functional iron insufficiency in the pediatric burn patient.

Findings:

  • Functional iron insufficiency was diagnosed in a pediatric burn patient based on specific hematologic markers.
  • Treatment with ferrous sulfate, along with age-appropriate dietary iron, led to a reticulocyte crisis and normalization of hematologic parameters.
  • The administration of iron supplementation was effective in resolving functional iron deficiency in this severe pediatric burn case.

Implications:

  • This case underscores the importance of monitoring and managing functional iron deficiency in children with severe burns.
  • Early and appropriate iron supplementation can significantly improve hematologic recovery in pediatric burn survivors.
  • Understanding functional iron deficiency is crucial for optimizing nutritional support and outcomes in pediatric burn care.

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