Mean Rise in Hemoglobin After Intravenous Iron Therapy in Children with Iron Deficiency Anemia

Authors

  • Ammara Mushtaq Khan Department of Pediatrics, Islamic International Medical College, Rawalpindi.
  • Sughra Zulfiqar Department of Pediatrics, Watim Medical College, Rawalpindi.
  • Amna Saleem Department of Pediatrics, Senior Registrar, Shifa college of medicine Islamabad.
  • Fahim Ahmed Subhani Department of Pediatrics, Islamic International Medical College, Rawalpindi.
  • Ammara Ayub Department of Pediatrics, Islamic International Medical College, Rawalpindi.
  • Tahira Khurram Deparment of Medicine, PHCC-HMC, Doha, Qatar.

DOI:

https://doi.org/10.47489/szmc.v38i1.414

Keywords:

Iron Deficiency Anemia, Hemoglobin, Intravenous iron

Abstract

Introduction: Iron deficiency anemia (IDA) is a significant public health issue in Pakistan, affecting up to 63% of children, as revealed by the Pakistan National Nutritional Survey 2018. While oral iron remains the primary choice, challenges in compliance have led to the consideration of intravenous (IV) iron therapy, particularly iron sucrose. The study discusses the safety and efficacy of IV iron therapy in Pakistani children and aims to broaden our understanding of treating IDA in resource-constrained regions.

Aims & Objectives: To determine the average hemoglobin (Hb) increase in iron-deficient-anemic children aged 01 to 12 years after treatment with intravenous iron sucrose.

Place and Duration of Study: A quasi-experimental study was undertaken at Fauji Foundation Hospital in Rawalpindi, spanning from September 2021 to September 2022.

Material & Methods: The study focused on a cohort of pediatric patients aged between 1 and 12 years, all of whom were diagnosed with iron deficiency anemia and had previously encountered ineffective outcomes with oral iron therapy. In this investigation, the patients received treatment involving intravenous iron sucrose. Subsequently, their progress was diligently monitored after a period of 8 weeks. Improvement in hemoglobin level was assessed at the end of treatment to evaluate its efficacy.Data processing and statistical analysis were carried out using SPSS version 23,p-value of <0.05 indicated statistical significance.

Results: Out of 150 study cases, 96 (64.0 %) were male, while 54 (36.0 %) were female. The mean age of our study cases was 05 ± 2.3 years of these 150 study cases, 74 (49.3 %) belonged to rural areas, and 76 (50.7 %) belonged to urban areas. Poor socioeconomic status was noted in 97 (64.7 %), and 53 (35.3%) were middle-income. A family history of iron deficiency anaemia was recorded in 16 (10.7%). Iron deficiency due to dietary iron insufficiency was reported in 67 (44.7%), Total Parentral Nutrition (TPN) dependencywas seen in 61 (40.7%) and 22 (14.7%) had chronic gastritis. The mean baseline (pretreatment) haemoglobin level was 7.71 ± 0.63 g/dl, while the mean post-treatment haemoglobin level was 10.68 ± 0.60 g / dl (p = 0.001).

Conclusion: After intravenous iron sucrose, we noted a significant rise in paediatric patients' hemoglobin levels, emphasizing its effectiveness and safety. Statistically, we found correlations with age, family history, and causes. Healthcare practitioners should consider injectable iron treatments for better results and reduced health issues in this group.

References

National Nutrition Survey 2018. Planning Commission, Planning and Development Division Government of Pakistan.

Wiegersma AM, Dalman C, Lee BK, Karlsson H, Gardner RM. Association of prenatal maternal anemia with neuro developmental disorders. JAMA psychiatry. 2019; 7(12):1294-304. doi:10.1001/jamapsychiatry.2019.2309.

Sangkhae V, Fisher AL, Wong S, Koenig MD, Tussing-Humphreys L, Chu A, et l. Effects of maternal iron status on placental and fetal iron homeostasis.JCIInsight.2019;17;1302. doi:10.1172/JCI127341.

Nestor JA, Afridi FA, Suarez R, Bou Karem J, Hardiman M, Hunter K. Iron Infusions in Pediatric Patients: A Single Institution Assessment of Efficacy and Adverse Effects of IV Iron Infusions. Blood. 2019;134(Suppl 1):5872. doi:10.1182/blood- 2019-123800. doi:10.1182/blood-2019-123800.

Mantadakis E, Chatzimichael E, Zikidou P. Iron deficiency anaemia in children residing in high and low-income countries: risk factors, prevention, diagnosis and therapy. Mediterr J Hematol Infect Dis. 2020;12: e2020041. doi:10.4084/mjhid.2020.041.

Mattiello V, Schmugge M, Hengartner H, von der Weid N, Renella R, et al. Diagnosis and management of iron deficiency in children with or without anaemia: consensus recommendations. Eur J Pediatr. 2020; 179:527–545. doi:10.1007/s00431- 020-03597-5.

Powers JM, Nagel M, Raphael JL, Mahoney DH, Buchanan GR, Thompson DI. Barriers to and facilitators of iron therapy in children with iron deficiency anaemia. J Pediatr. 2020; 219:202-208. doi 10.1016/j.jpeds.2019.12.040.

Muñoz M, Gómez-Ramírez S, Bhandari S. The safety of available treatment options for iron- deficiency anemia. Expert opinion on drug safety. 2018;17(2): 14959.doi:10.1080/14740338.2018.1400009.

Neogi SB, Devasenapathy N, Singh R, Bhushan H, Shah D, Divakar H, et al. Safety and effectiveness of intravenous iron sucrose versus standard oral iron therapy in pregnant women with moderate-to-severe anaemia in India: a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Glob Health. 2019;7(12): e170616.doi:10.1016/S221410X(19)30427-9.

Pinsk V, Levy J, Moser A, Yerushalmi B, Kapelushnik J. Efficacy, and safety of intravenous iron sucrose therapy in a group of children with iron deficiency anemia. Isr Med Assoc J 2018; 10(5):335-8.

Khan S, Iqbal I, Abbas A, Arshad R, Ali I, Khan S, Ijaz A. Parental Iron Therapy to Treat Iron Deficiency Anemia in Malnourished Children. J Islamic Int Med Coll. 2022;17(4)

Nazir F, Khurshid A, Talib MA. Intravenous Iron Sucrose in Malnourished Children with Iron Deficiency Anemia. Professional Med J 2020;27(9): 1867-1871.doi: 10.29309/TPMJ/2020.27.09.4107

United Nations Children's Fund (UNICEF), World Health Organization, International Bank for Reconstruction and Development/The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 edition of the joint child malnutrition estimates. Available online at url: https://data.unicef.org/resources/jme-report-2021

Sheikh MA, Rabbani MW, Fozia AA, Iqbal I. Efficacy of intravenous iron sucrose infusion in children with iron deficiency anemia: Experience at children hospital & ICH Multan. Med Forum 2018; 26(1):62-5.

Zaman S, Shah SA, Jehanzeb K, Sabir S, Rashid HU, Haq ZU. Effect of intravenous iron therapy on serum ferritin and haemogobin levels in children reporting with iron deficiency anaemia. Pak Armed Forces Med J 2020;70(5): 1344-48.

Ozsahin H, Schaeppi M, Bernimoulin M, Allard M, Guidard C, van den Ouweland F. Intravenous ferric carboxymaltose for iron deficiency anaemia or iron deficiency without anaemia after poor response to oral iron treatment: Benefits and risks in a cohort of 144 children and adolescents. Pediatr Blood Cancer. 2020;67(10): E28614. doi:10.1002/pbc.28614.

Mantadakis E, Tsouvala E, Xanthopoulou V, Chatzimichael A. Intravenous iron sucrose for children with iron deficiency anemia: a single institution study. World J Pediatr 2019; 12(1): 109- 13.doi:10.1007/s12519-015-0010-x

Papadopoulos M, Patel D, Korologou-Linden R, Goto E, Soondrum K, Fell JM, et al. Safety and efficacy of parenteral iron in children with inflammatory bowel disease. Br J Clin Pharmacol 2018; 84(4): 694-9.doi: 10.1111/bcp.13493.

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Published

2024-02-02

How to Cite

1.
Ammara Mushtaq Khan, Zulfiqar S, Amna Saleem, Fahim Ahmed Subhani, Ammara Ayub, Tahira Khurram. Mean Rise in Hemoglobin After Intravenous Iron Therapy in Children with Iron Deficiency Anemia. Proceedings S.Z.M.C [Internet]. 2024 Feb. 2 [cited 2024 Apr. 24];38(1):45-50. Available from: http://proceedings-szmc.org.pk/index.php/szmc/article/view/414