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Diagnosing iron deficiency in cyanotic heart disease
Cemile Banu Onur1, Tansu Sipahi, Betül Tavil
1Dr. Sami Ulus Children Hospital, Ankara, Turkey.
Insights
Diagnosing iron deficiency in children with cyanotic congenital heart disease (CCHD) can be effectively done using simple, inexpensive lab tests like MCV and RDW, rather than traditional blood counts.
Area of Science:
- Pediatric Cardiology
- Hematology
- Nutritional Science
Background:
- Cyanotic congenital heart disease (CCHD) affects oxygen transport and can influence iron metabolism.
- Iron deficiency is a common comorbidity in children, potentially exacerbating CCHD-related issues.
- Noninvasive and cost-effective diagnostic methods are crucial for managing pediatric CCHD patients.
Purpose of the Study:
- To establish the incidence of iron deficiency in children with CCHD.
- To evaluate the utility of noninvasive, inexpensive laboratory methods for diagnosing iron deficiency in this population.
- To compare the effectiveness of different hematological parameters in identifying iron deficiency in CCHD.
Main Methods:
- A cohort of 44 children (6-48 months) with CCHD was studied.
- Patients were classified into iron-deficient (n=28) and iron-sufficient (n=16) groups.
- Hematological parameters including MCV, MCH, RDW, SI, TIBC, and serum ferritin were measured at baseline and after 3 months of iron treatment for deficient patients.
Main Results:
- Hemoglobin, hematocrit, and RBC counts were not significant indicators of iron deficiency in children with CCHD.
- Mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW) showed diagnostic value.
- Serum iron (SI), total iron binding capacity (TIBC), and serum ferritin levels also aided in diagnosis.
Conclusions:
- Standard hemoglobin, hematocrit, and RBC counts are unreliable for diagnosing iron deficiency in CCHD.
- MCV, MCH, and RDW provide an easy, inexpensive, and low-volume blood requirement for diagnosing iron deficiency in CCHD follow-up.
- These red blood cell indices offer a practical approach for monitoring iron status in pediatric CCHD patients.
Objective:
To determine the incidence of iron deficiency in children with CCHD by noninvasive, inexpensive and easy laboratory methods.
Methods:
Forty four children with cyanotic congenital heart disease (CCHD), aged 6 to 48 months were included in this study. The patients were categorized as iron deficient (n:28) and iron sufficient group (n:16). Children with CCHD who had iron deficiency were treated with iron for 3 months.
Result:
Iron sufficient patients were followed during 3 months without giving iron preparation. Mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red cell distribution width (RDW), serum iron (SI), total iron binding capacity (TIBC) and serum ferritin levels were measured in all patients at the beginning and at the end of the study.
Conclusion:
In children with CCHD, hemoglobin (Hb), hematocrit (Hct) and red blood cell (RBC) counts were not considered significant parameters in the diagnosis of iron deficiency. Determination of MCV, MCH, RDW values is relatively easy and inexpensive method requiring small amount of blood for the diagnosis of iron deficiency during the follow-up of patients with CCHD.