Pediatric Crohn's disease, iron deficiency anemia and intravenous iron treatment: a follow-up study

Abstract

In pediatric IBD iron anemia, the evidence supporting the efficacy and safety of IV-iron is scare. This prospective study aims to evaluate the safety and efficacy (short and long term) of IV-iron in these patients. Nineteen pediatric CD patients were evaluated before and after IV iron treatment (40-month period).The median Hb before and after IV iron was 10.5 and 12.7 g/dl, respectively. No major adverse reactions were documented. Six patients needed re-treatment (median period of 15.5 months). This study further demonstrates the efficacy and safety of IV iron. It reinforces the importance of long-term follow-up of the iron status in pediatric CD patients.

Prevalence of iron deficiency anemia and iron deficiency in a pediatric population with inflammatory bowel disease

“…Recently, its gastrointestinal side-effects, slow onset of action and negative impact on disease activity gave rise to the use of intravenous formulations [2,5,6,9,[13][14][15]. There have been some concerns regarding the safety of these preparations in the pediatric population, mainly with dextran formulations which carry increased risk of anaphylaxis [6,8,9,15,16].…”

“…ID has an adverse impact on quality of life [6,9,11,12]. Therefore, it is important to carefully evaluate iron status of all patients so that ID and IDA can be diagnosed and treated timely [7,8].…”

“…The true prevalence of iron deficiency (ID) and IDA in the pediatric population is unknown. In recent studies, Goodhand et al and later Danko estimated it to be up to 70% at diagnosis and even after two years of follow-up prevalence can be as high as 30% [2,[4][5][6][7][8][9][10].…”

“…Recently, its gastrointestinal side-effects, slow onset of action and negative impact on disease activity gave rise to the use of intravenous formulations [2,5,6,9,[13][14][15]. There have been some concerns regarding the safety of these preparations in the pediatric population, mainly with dextran formulations which carry increased risk of anaphylaxis [6,8,9,15,16]. But, now, the new formulas such as iron sucrose and ferric carboxymaltose (FCM), the last one still only approved for patients over 14 years, have better safety profiles and are now the first line treatment for IDA and ID in IBD patients [3,4,8,9,[16][17][18].…”

“…In context of IBD, interpreting serum ferritin relative to C-reactive protein has been proposed as a method to detect iron deficiency [2,8,9].…”