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Iron deficiency in childhood and adolescence: retrospective review
M Ferrara1, L Coppola, A Coppola
1Department of pediatrics, The 2nd university of naples, Naples, Italy. mara.ferrara@unina2.it
Insights
Iron deficiency anemia (IDA) in children has diverse causes beyond inadequate intake, including blood loss and malabsorption. Accurate diagnosis is crucial before initiating iron replacement therapy.
Area of Science:
- Pediatrics
- Hematology
- Gastroenterology
Background:
- Iron deficiency (ID) and iron deficiency anemia (IDA) are common in children.
- Identifying the underlying cause is essential for effective treatment.
Purpose of the Study:
- To retrospectively review causes of ID/IDA in pediatric patients.
- To determine the most appropriate treatment strategies based on etiology.
Main Methods:
- Retrospective chart review of 238 pediatric patients with ID/IDA.
- Analysis of patient demographics, clinical presentation, and diagnostic findings.
Main Results:
- Inadequate iron intake (59 cases), cow's milk intolerance (37 cases), Meckel's diverticulum (6 cases), reflux esophagitis (10 cases), NSAID use (11 cases), and polymenorrhea (16 cases) were identified causes.
- Malabsorption due to celiac disease (37 cases), H. pylori infection (39 cases), or enteromonas infection (15 cases) presented as causes, often unresponsive to iron therapy.
Conclusions:
- Diverse etiologies contribute to pediatric ID/IDA, including nutritional, gastrointestinal bleeding, and malabsorptive conditions.
- Iron replacement therapy should be guided by a confirmed diagnosis and may not always be the primary treatment.
Abstract:
Two hundred and thirty-eight subjects of both sexes, age range 7.5 months-16 years, with iron deficiency (ID), were included in a retrospective review of ID causes, to determine the best treatment. Inadequate iron intake was the cause of ID or iron deficiency anemia (IDA) in 59 subjects from the first months of life to adolescence. Blood loss linked to cow's milk intolerance was the cause of ID or IDA in 37 younger children. Meckel's diverticulum (MD) (6 cases), reflux esophagitis (RE) (10 cases), some drugs such as acetyl salicylic acid (11 cases) induced bleeding with ID or IDA in children and adolescents. In pubertal females with ID or IDA, polymenorrhea was observed in 16 cases. Coelic disease (CD) (37 cases), Helicobacter pylori infection (HPI) (39 cases), association of HPI and CD (8 cases), enteromonas infection (15 cases), determining particularly malabsorption, were causes of ID or IDA in patients of a wide age range, unresponsive to iron therapy. Our findings show that iron replacement therapy was not always required and should not be prescribed until the diagnosis is certain.
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