J Korean Med Assoc.  2011 Jul;54(7):725-729.

Iron deficiency anemia in childhood

Affiliations
  • 1Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea. shoopyi@hanmail.net

Abstract

Iron deficiency anemia (IDA) frequently occurs in infants and adolescents. IDA is the result of an interplay between increased host requirements, limited external supply, and increased blood loss. In outpatient clinics, we often see children with iron deficiency anemia. Most cases in children are caused by incomplete nutrient supplements and growth spurts. However, we can occasionally see patients with poor response despite iron supplementation. Failure of iron therapy occurs when a child does not receive the prescribed medication, when iron is given in a form that is poorly absorbed, or when there is a continuing unrecognized blood loss such as intestinal or pulmonary loss, or loss with menstrual periods. In addition, the therapeutic failure of iron medication may indicate that the original diagnosis of nutritional iron deficiency was incorrect. In this situation, we have to evaluate other etiologies of anemia. Recently, many cases relating H.pylori infection to iron deficiency anemia have been described in the literature and H.pylori infection has emerged as a cause of refractory iron deficiency anemia that is unresponsive to oral iron therapy. Also, iron deficiency anemia induced by athletics in adolescent females has been reported several times. In this article, the author reviews various etiologies of childhood iron deficiency anemia. The most important consideration in treatment of iron deficiency anemia is disclosure of the underlying cause and its recovery. Dietary habits should also be corrected. To supplement iron, 6 mg/kg of oral iron supplements (elemental iron) is recommended in ferrous salt form. If oral administration is not feasible, intravenous supplementation is recommended using forms such as iron dextran, iron gluconate, or iron sucrose.

Keyword

Iron deficiency anemia; Childhood; Etiology; Therapeutics

MeSH Terms

Administration, Oral
Adolescent
Ambulatory Care Facilities
Anemia
Anemia, Iron-Deficiency
Child
Dextrans
Disclosure
Female
Ferric Compounds
Food Habits
Glucaric Acid
Gluconates
Humans
Infant
Iron
Sports
Sucrose
Dextrans
Ferric Compounds
Glucaric Acid
Gluconates
Iron
Sucrose

Reference

1. Lim YT. Differential diagnosis and treatment of anemia in children. Korean J Pediatr. 2005. 48:121–125.
2. Kim HJ, Shin MY, Kim SS, Park JO, Kim CH. A study on the incidence of anemia according to feeding patterns and the status of weaning diet. Korean J Pediatr. 2009. 52:875–880.
Article
3. Yun HJ, Choi EJ, Choi EJ, Hong SY. A comparative study on iron deficiency anemia based on feeding patterns of nine-month-old infants. Korean J Pediatr. 2008. 51:820–826.
Article
4. Kim SJ, Kim DH, Chang JH, Jun YH, Hong YJ, Son BK, Kim SK. A study of mothers knowledge of weaning of infants with iron-deficiency anemia. Korean J Pediatr. 2008. 51:468–473.
Article
5. Kwak GY, Lee NY, Lee MH, Lee SY, Chung SY, Kang JH, Jeong DC. A case of idiopathic pulmonary hemosiderosis with seasonal recurrence. Korean J Pediatr. 2009. 52:256–260.
Article
6. Choe YH. Helicobacter pylori infection in children: recommendations for diagnosis and treatment. Korean J Pediatr. 2004. 47:235–239.
7. Ashorn M, Ruuska T, Makipernaa A. Helicobacter pylori and iron deficiency anaemia in children. Scand J Gastroenterol. 2001. 36:701–705.
Article
8. Kostaki M, Fessatou S, Karpathios T. Refractory iron-deficiency anaemia due to silent Helicobacter pylori gastritis in children. Eur J Pediatr. 2003. 162:177–179.
Article
9. Chey WD, Wong BC. Practice Parameters Committee of the American College of Gastroenterology. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007. 102:1808–1825.
Article
10. Choe YH. Treatment of H. pylori-associated extragastric diseases. Korean J Med. 2008. 75:508–514.
11. Beard J, Tobin B. Iron status and exercise. Am J Clin Nutr. 2000. 72:2 Suppl. 594S–597S.
Article
12. Ehn L, Carlmark B, Hoglund S. Iron status in athletes involved in intense physical activity. Med Sci Sports Exerc. 1980. 12:61–64.
Article
13. Rowland TW. Iron deficiency in the young athlete. Pediatr Clin North Am. 1990. 37:1153–1163.
Article
14. Kim SK, Kim CS, Choi JW, Cho MH, Kim KH, Chang KJ. Iron status in adolescent female athletes. Korean J Hematol. 2003. 38:240–245.
15. Merkel D, Huerta M, Grotto I, Blum D, Rachmilewitz E, Fibach E, Epstein Y, Shpilberg O. Incidence of anemia and iron deficiency in strenuously trained adolescents: results of a longitudinal follow-up study. J Adolesc Health. 2009. 45:286–291.
Article
16. Peeling P, Dawson B, Goodman C, Landers G, Trinder D. Athletic induced iron deficiency: new insights into the role of inflammation, cytokines and hormones. Eur J Appl Physiol. 2008. 103:381–391.
Article
17. Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics. 2001. 107:1381–1386.
Article
18. Cho JR, Kim SK, Park SK, Hah JO. Anemia and serum iron status in adolescent female. J Korean Pediatr Soc. 2002. 45:362–369.
19. Greydanus DE, Patel DR. The female athlete. Before and beyond puberty. Pediatr Clin North Am. 2002. 49:553–580.
20. Annibale B, Capurso G, Chistolini A, D'Ambra G, DiGiulio E, Monarca B, DelleFave G. Gastrointestinal causes of refractory iron deficiency anemia in patients without gastrointestinal symptoms. Am J Med. 2001. 111:439–445.
Article
21. Hershko C, Ronson A. Iron deficiency, Helicobacter infection and gastritis. Acta Haematol. 2009. 122:97–102.
Article
22. The Korean Society of Pediatrics. Ahn HS, editor. Blood disorders. Pediatrics. 2004. 8th ed. Seoul: Daehan Printing & Publishing Co.;813–817.
Full Text Links
  • JKMA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr