Ferumoxytol infusion in pediatric patients with gastrointestinal disorders: first case series

To report our preliminary experience using ferumoxytol as intravenous iron therapy for treating iron deficiency anemia in 6 pediatric patients with underlying gastrointestinal disease.

Between October 2010 and February 2011, 6 patients aged 6 months to 16 years who had malabsorption and/or ongoing gastrointestinal blood loss were given ferumoxytol infusions at a dose of 5.8-12 mg elemental iron/kg over 15-60 minutes, followed by 1 hour of observation to monitor for adverse effects.

Thirteen separate ferumoxytol administrations were given to 6 pediatric patients with various gastrointestinal diseases, including inflammatory bowel disease and short bowel syndrome, and/or chronic parenteral nutrition dependence. Twelve of 13 infusions were well tolerated at 5.8-12 mg elemental iron/kg/dose. No patient experienced adverse events that required clinical intervention. One patient developed mild pruritus that resolved spontaneously.

Ferumoxytol doses of up to 12 mg elemental iron/kg administered over 15-60 minutes seem to be well tolerated in pediatric patients. Larger prospective studies are needed to determine the incidence and severity of adverse effects associated with ferumoxytol, both during administration and immediately after. Long-term studies will be required to assess to risk for iron overload toxicity.