Response to parenteral iron therapy distinguish unexplained refractory iron deficiency anemia from iron-refractory...

Area of Science:

• Pediatric Hematology
• Nutritional Anemias
• Iron Metabolism

Background:

• Iron deficiency anemia (IDA) presents diagnostic challenges, particularly differentiating subtypes.
• Unexplained refractory iron deficiency anemia (URIDA) and iron-refractory iron deficiency anemia (IRIDA) require distinct management approaches.
• Parenteral iron therapy's differential response may aid in classifying IDA.

Purpose of the Study:

• To evaluate the efficacy of intravenous iron sucrose therapy in children with URIDA.
• To compare the therapeutic response in URIDA patients with those of IRIDA patients.
• To determine if response to parenteral iron can distinguish between URIDA and IRIDA.

Main Methods:

• A cohort of 15 children with URIDA received IV iron sucrose therapy.
• Blood parameters (Hb, MCV, MCH, ferritin) were assessed at diagnosis, 6 weeks, and 6 months post-therapy.
• Results were compared to a previous study of 11 IRIDA patients.

Main Results:

• In URIDA patients, significant improvements in Hb, MCV, MCH, and ferritin were observed within 6 weeks, with most parameters normalizing.
• Five URIDA patients showed near-normal hematological indices but below-normal ferritin levels.
• IRIDA patients exhibited a partial response to parenteral iron, with smaller increases in blood parameters compared to URIDA.

Conclusions:

• Intravenous iron therapy significantly improved hematological parameters in URIDA patients.
• The robust response to parenteral iron in URIDA contrasts with the partial response in IRIDA.
• Parenteral iron therapy response serves as a valuable clinical tool for differentiating URIDA from IRIDA in settings lacking genetic testing.