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How I approach iron deficiency with and without anemia
Jacquelyn M Powers1,2, Sarah H O'Brien3,4
1Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine, Houston, Texas.
Insights
Iron deficiency anemia is common in children, especially young ones and adolescent females. New insights into iron regulation and safer treatments offer updated care options for affected pediatric patients.
Area of Science:
- Pediatric Hematology-Oncology
- Iron Homeostasis
- Nutritional Anemia
Background:
- Iron deficiency anemia (IDA) is a frequent reason for pediatric hematology-oncology referrals.
- Understanding iron metabolism, including the hormone hepcidin, is crucial for managing IDA.
- Recent advancements in intravenous iron formulations offer safer treatment options.
Observation:
- Young children and adolescent females are the most commonly affected demographics.
- Children with complex medical histories or chronic inflammatory conditions require special attention.
- Comorbid gastrointestinal disorders can complicate iron absorption and treatment.
Findings:
- Improved knowledge of iron homeostasis guides current treatment strategies.
- Clinical trial data from adults and children inform pediatric IDA management.
- Safer intravenous iron formulations expand therapeutic possibilities.
Implications:
- Treatment recommendations for pediatric IDA necessitate updated considerations.
- Personalized approaches are needed for children with complex health issues.
- Further research may optimize the use of novel iron therapies in pediatric populations.
Abstract:
Iron deficiency anemia remains a common referral to the pediatric hematology-oncology subspecialist. Improved understanding of iron homeostasis, including the effects of the regulatory hormone hepcidin, recent adult and pediatric clinical trial data, as well as the availability of safer formulations of intravenous iron, have resulted in additional considerations when making treatment recommendations in such patients. Young children and adolescent females remain the most commonly affected groups, but children with complex medical or chronic inflammatory conditions including comorbid gastrointestinal disorders also require special consideration.
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