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Parameters of iron deficiency in children with cyanotic congenital heart disease
1Department of Pediatrics, Hacettepe University Faculty of Medicine, 06100 Ankara Turkey.
Insights
Iron deficiency in children with cyanotic congenital heart disease (CCHD) can be diagnosed using simple hemoglobin, hematocrit, and MCV measurements. These inexpensive tests help identify iron deficiency without impacting systemic perfusion.
Area of Science:
- Pediatric Cardiology
- Hematology
- Nutritional Deficiencies
Background:
- Cyanotic congenital heart disease (CCHD) is associated with complex hematological changes, including erythrocytosis.
- Iron deficiency can coexist with erythrocytosis in CCHD patients, complicating diagnosis and management.
- Accurate assessment of iron status is crucial for optimizing care in this vulnerable population.
Purpose of the Study:
- To evaluate the utility of simple hematological parameters for diagnosing iron deficiency in children with CCHD.
- To assess the impact of iron treatment on hematological indices in iron-deficient and iron-sufficient CCHD patients.
Main Methods:
- A cohort of 67 children with CCHD was studied, with 35 receiving iron supplementation based on hematocrit levels.
- Patients were classified as iron-deficient or iron-sufficient using transferrin saturation and ferritin levels.
- Hemoglobin (Hb), hematocrit (Hct), erythrocyte (RBC) count, and mean corpuscular volume (MCV) were measured pre- and post-treatment.
Main Results:
- Iron-deficient CCHD patients exhibited significant erythrocytosis and low MCV (<72.7 fl) pre-treatment.
- Iron treatment led to significant increases in Hb, Hct, transferrin saturation, and ferritin in both groups, with greater improvements in the iron-deficient group.
- MCV significantly increased in iron-deficient patients post-treatment, while RBC count increments were significant in the iron-sufficient group.
Conclusions:
- Simple, inexpensive hematological measurements (Hb, RBC count, MCV) can effectively diagnose iron deficiency in CCHD patients.
- These diagnostic methods do not require alterations in systemic perfusion, making them practical for clinical use.
- Early identification and treatment of iron deficiency can improve hematological parameters in children with CCHD.
Abstract:
A group of 67 children with cyanotic congenital heart disease (CCHD) were studied, and 35 were given iron treatment according to a regimen that gives iron to patients with a hematocrit (Hct) below 60%. The patients were categorized as iron-deficient and iron-sufficient according to their transferrin saturation and ferritin values. The pretreatment hemoglobin (Hb) and Hct values of the groups were similar. The mean Hct was nearly three times as much as the mean Hb in the iron-sufficient group and more than three times as much as the Hb in the iron-deficient group. Excessive erythrocytosis in the iron-deficient group was impressive. Mean corpuscular volume (MCV) values were below 72.7 fl in all of the iron-deficient patients. After treatment the Hb, Hct, transferrin saturation, and ferritin increased significantly in both groups, with the increments greater in the iron-deficient group. Increments in the erythrocyte (RBC) count were significant in the iron-sufficient group but insignificant in the iron-deficient one. Increments of MCV in the iron-deficient group were significant but insignificant in the iron-sufficient group. Our study demonstrated that prediction of Hb, RBC count, and MCV, measurements of which are easy and inexpensive and require little blood, can suffice for the diagnosis of iron deficiency in patients with CCHD without altering systemic perfusion.