Low iron stores in infants and children with treated phenylketonuria: A population at risk for iron-deficiency anaemia and associated cognitive deficits

Implication of iron deficiency Causes of iron deficiency Overt or occult bleeding Diagnosing iron deficiency Presentation and investigations Treatment Anaemia of chronic disease In the developed world, the commonest cause of iron deficiency anaemia (IDA) and its prelude iron deficiency is menstrual blood loss. Worldwide, hookworm infection is prevalent and causes IDA in those with heavy parasite load. About 4% of men/post-menopausal women have iron deficiency, and 1–2% have related IDA. Iron deficiency rises to ~20% in pre-menopausal women (remainder often have considerably reduced iron stores)....

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Safety and Efficacy of Intravenous Ferric Carboxy Maltose in Iron Deficiency Anaemia During Postpartum Period

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v15i3.18841 ◽

2018 ◽

Vol 15 (3) ◽

pp. 208-211 ◽

Cited By ~ 2

Author(s):

Vineet Mishra ◽

Priyankur Roy ◽

Khushali Gandhi ◽

Sumesh Choudhary ◽

Rohina Aggarwal ◽

...

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Binding Capacity ◽

World Health Organisation ◽

World Health ◽

Serious Adverse Events ◽

Deficiency Anaemia ◽

Iron Stores ◽

Mild Anaemia ◽

High Doses

Background: Iron deficiency is the commonest treatable cause of postpartum anaemia. Parenteral iron therapy results in faster and higher replenishment of iron stores and correction of haemoglobin levels with better compliance. Ferric Carboxy Maltose is an effective and a safe option which can be administered intravenously in single total correction dose without any serious adverse effects.The study was done to evaluate the efficacy and safety of Ferric Carboxy Maltose in the treatment of iron deficiency anaemia in post-natal patients.Methods: It was an open, single arm study including 615 women with diagnosis of Iron deficiency anaemia and haemoglobin (Hb) levels between 4gm% and 11gm% from January 2013 to December 2016. Intravenous Ferric Carboxy Maltose(500-1500mg) was administered and the improvement in haemoglobin levels and iron stores were assessed after three weeks of total dose infusion.Results: Out of the 615 women, 595 women were included in the analysis. Most of the women were in the age group of 27-30 years. Most of the women had mild anaemia as per World Health Organisation guidelines. Mean hemoglobin levels significantly increased over a period of three weeks after Ferric Carboxy Maltose administration. Other parameters like total iron binding capacity, Ferritin and Iron also had a significant improvement after Ferric Carboxy Maltose administration. No serious adverse events were observed after Ferric Carboxy Maltose.Conclusions: Intravenous Ferric Carboxy Maltose was an effective and a safe treatment option for iron deficiency anaemia and has an advantage of single administration of high doses without serious adverse effects.

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Comparative study of efficacy and safety of parenteral iron sucrose versus ferric carboxymaltose in treatment of postpartum iron deficiency anaemia

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20215083 ◽

2021 ◽

Vol 11 (1) ◽

pp. 100

Author(s):

Ganesh N. Dakhle ◽

Mrunalini V. Kalikar ◽

Rujuta P. Fuke ◽

Anisha S. Parmarthi ◽

Mrunalini K. Chokhandre

Keyword(s):

Iron Deficiency ◽

Serum Ferritin ◽

Iron Deficiency Anaemia ◽

Maximum Dose ◽

Iron Sucrose ◽

Ferric Carboxymaltose ◽

Care Hospital ◽

Deficiency Anaemia ◽

Iron Stores ◽

Parenteral Iron

Background: Postpartum anaemia often leads to multiple clinical complications in mother as well as infant and iron supplementation with parenteral iron is the preferred treatment modality. The present study was planned to compare the efficacy and tolerability of IV iron sucrose and IV ferric carboxymaltose in treatment of postpartum iron deficiency anaemia.Methods: This randomized, parallel, open label, prospective 4-weeks study was conducted from June 2019 to December 2020 in women with postpartum anaemia admitted to obstetrics and gynaecology inpatient department of a tertiary care hospital. Women with postpartum iron deficiency anaemia (N=60) were randomly divided into two groups; receiving Injection iron sucrose (N=30, maximum dose 500 mg) or Injection ferric carboxymaltose (N=30, maximum dose 500 mg). Change in haemoglobin and serum ferritin levels from baseline to the end of 2 and 4 weeks of treatment were evaluated.Results: The results showed early, sustained and significant increase in the haemoglobin levels in both the groups. However, the difference was not significant between groups (p=0.2). Evaluation of replenishment of iron stores (serum ferritin) showed improvement in both the groups, however in FCM group the rise was found to be significant (p<0.05).Conclusions: FCM in a lower dose of 500mg was found to be safe and effective in significantly improving haemoglobin concentration as well as in replenishing iron stores in patients with postpartum anaemia.

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A REVIEW ON COMPARITIVE STUDY ON SAFETY AND EFFECTIVENESS OF IV FERRIC CARBOXY MALTOSE VERSUS IRON SUCROSE IN PATIENTS WITH IRON DEFICIENCY ANAEMIA OF CKD

International Journal of Pharmaceutical and Biological Science Archive ◽

10.32553/ijpba.v7i2.123 ◽

2019 ◽

Vol 7 (2) ◽

Author(s):

LAYANA V. S ◽

RANI MANJU ◽

MATHEW GEORGE ◽

LINCY JOSEPH

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Intravenous Iron ◽

Iron Sucrose ◽

Deficiency Anemia ◽

Deficiency Anaemia ◽

Body Iron ◽

Iron Stores

Deficiency of iron is one of the most common nutritional disorders in the society. Iron deficiency anemia is described as decreased production in red blood cells (RBCs) due to low body iron stores.Anemia commonly occurs in people with chronic kidney disease and it might begin to develop in the early stages and tends to worsen as disease progresses. Iron supplementation is mandatory in the majority of patients with renal disease, particularly in those receiving ESA therapy. Treatment with intravenous iron in some clinical situations could present some advantages over oral iron, such as faster and higher increases of hemoglobin (Hb) levels and body iron stores. Some modern formulations of intravenous iron have emerged as a safe and effective alternative for iron deficiency anaemia management. E.g.: iron sucrose. Ferric carboxy maltose is a parenteral iron dextran-free product and the first of the new agents approved for rapid and high-dose replenishment of depleted iron stores. Keywords: Iron deficiency anaemia, chronic kidney disease, hemoglobin, iron sucrose, ferric carboxy maltose

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Incidence of Iron-deficiency Anaemia and Depleted Iron Stores Among Nine-month-old Infants in Vancouver, Canada

Can J Public Health ◽

10.1007/bf03403865 ◽

1997 ◽

Vol 88 (2) ◽

pp. 80-84 ◽

Cited By ~ 37

Author(s):

Sheila M. Innis ◽

Carolanne M. Nelson ◽

Louis D. Wadsworth ◽

Ian A. MacLaren ◽

Dorcas Lwanga

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anaemia ◽

Deficiency Anaemia ◽

Iron Stores

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Ferritin in Serum: Diagnosis of Iron Deficiency and Iron Overload in Infants and Children

Blood ◽

10.1182/blood.v43.4.581.581 ◽

1974 ◽

Vol 43 (4) ◽

pp. 581-590 ◽

Cited By ~ 218

Author(s):

Martti A. Siimes ◽

Joseph E. Addiego ◽

Peter R. Dallman

Keyword(s):

Iron Deficiency ◽

Iron Overload ◽

Serum Ferritin ◽

Infants And Children ◽

Deficiency Anemia ◽

Ferritin Concentration ◽

Iron Stores ◽

Serum Ferritin Concentration ◽

Wide Range ◽

In Infants And Children

Abstract Ferritin in serum was quantitated by radioimmunoassay to determine the usefulness of this assay in reflecting iron stores during normal development and in the diagnosis of iron deficiency and iron overload in infants and children. In the adult, serum ferritin has been reported to correspond to the magnitude of iron stores throughout a wide range. In 573 normal infants and children, we found the concentration of serum ferritin to parallel known changes in iron stores during development. The median serum ferritin concentration was 101 ng/ml at birth, rose to 356 ng/ml at 1 mo of age, and then fell rapidly to a median value near 30 ng/ml (95% confidence limits: 7-142 ng/ml) between 6 mo and 15 yr of age. In the adult, median concentrations diverged according to sex, 39 ng/ml in the female and 140 ng/ml in the male. In 13 children with iron-deficiency anemia, the serum ferritin concentration was 9 ng/ml or less. Overlap with the normal population was small, and no conditions were found to give "false" low values. In children with β-thalassemia major and sickle cell anemia, median values were elevated to 850 and 160 ng/ml, respectively. Possibly misleading, elevated values were obtained in some patients with acute infection and in acute lymphoblastic leukemia. The serum ferritin assay promises to be a useful tool in the evaluation of iron status, particularly in children.

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Factors associated with iron deficiency anaemia among pregnant teenagers in Ashanti Region, Ghana: A hospital-based prospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0250246 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250246

Author(s):

Reginald Adjetey Annan ◽

Linda Afriyie Gyimah ◽

Charles Apprey ◽

Anthony Kwaku Edusei ◽

Odeafo Asamoah-Boakye ◽

...

Keyword(s):

Cohort Study ◽

Iron Deficiency ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Associated Factors ◽

Iron Deficiency Anaemia ◽

Serum Levels ◽

Deficiency Anaemia ◽

Body Iron ◽

Iron Stores

Background Iron Deficiency Anaemia (IDA) is reportedly high in pregnant adults and the causes well studied. However, among pregnant teenagers, the levels and associated factors of IDA are not fully understood. Methods In a prospective cohort study among Ghanaian pregnant teenagers, aged 13–19 years, IDA prevalence and associated factors were investigated. Sociodemographic data, household hunger scale (HHS), lived poverty index (LPI), FAO’s women’s dietary diversity score (WDDS) and interventions received during antenatal care (ANC) were obtained from 416 pregnant teenagers in Ashanti Region, Ghana. Micronutrient intakes using a repeated 24-hour dietary recall, and mid-upper arm circumference (MUAC) were determined and blood samples analysed for haemoglobin (Hb), serum levels of ferritin, prealbumin, vitamin A, total antioxidant capacity (TAC), C-reactive protein (CRP), and zinc protoporphyrin (ZPP). Results Anaemia (Hb cutoff <11.0 g/dL) was 57.1%; deficient systemic supply of iron stores (31.4%), depleted body stores of iron (4.4%), inadequate dietary iron intake (94.5%), and inadequate multiple micronutrient intakes (49.5%), were all notable among study participants. Between-subject effects using Generalized Linear Modelling indicated malaria tablet given at ANC (p = 0.035), MUAC (p = 0.043), ZPP (p<0.001), ZPP/Hb ratio (p<0.001) and depleted body iron stores (DBIS) (p<0.001) to significantly affect Hb levels. Pregnant teenagers with a high ZPP/Hb ratio (OR = 9.7, p<0.001, 95%CI = 6.0–15.8) had increased odds of being anaemic compared to those with normal ZPP/Hb ratio. Participants who were wasted (OR = 1.2, p = 0.543, 95%CI = 0.6–2.3), and those with depleted iron stores (OR = 3.0, p = 0.167, 95%CI = 0.6–14.6) had increased odds of being anaemic. Participants who experienced hunger were close to 3 times more likely (OR = 2.9, p = 0.040, 95%CI = 1.1–7.8) for depleted iron stores, compared to those who did not experience hunger. Also, participants with inadequate multiple micronutrients intakes (OR = 2.6, p = 0.102, 95%CI = 0.8–8.4), and those with low serum levels of ferritin (OR = 3.3, p = 0.291, 95%CI = 0.4–29.2) had increased odds of depleted body iron stores. Conclusions IDA is common among pregnant teenagers and the related factors include malaria tablets given at ANC, maternal hunger, maternal MUAC, a deficient systemic supply of iron, depleted body iron stores, ZPP, and ZPP/Hb ratio. Appropriate interventions are urgently needed to address the causes of IDA among pregnant teenagers.

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