J Korean Med Assoc.  2016 Sep;59(9):678-682. 10.5124/jkma.2016.59.9.678.

Iron-deficiency anemia in children: from diagnosis to treatment

• Lee JH

• KMID: 2391983
• DOI: http://doi.org/10.5124/jkma.2016.59.9.678

Abstract

Iron-deficiency anemia (IDA) is the most frequent hematologic and nutritional disorder in children. The risk factors associated with IDA in children are rapid growth with inadequate dietary iron, low birth weight, premature birth, perinatal bleeding, early cow's milk intake, and breastfeeding beyond 6 months without iron supplementation. Blood loss is also an important cause of IDA. Most children with IDA are asymptomatic and may go undiagnosed. The diagnosis of IDA is confirmed by microcytic hypochromic anemia and a low level of serum ferritin. Monitoring the response to iron supplementation is a reasonable intervention for a clinically stable child with mild anemia and inadequate iron intake. IDA must be differentiated from the anemia that arises from chronic disease and thalassemia. Oral iron is usually recommended as first-line therapy. Parenteral iron is indicated in cases of poor compliance or failure of oral iron, intestinal malabsorption, or chronic bleeding.

Keyword

Iron-deficiency anemia; Child; Hypochromic microcytic anemia

MeSH Terms

Anemia
Anemia, Hypochromic
Anemia, Iron-Deficiency*
Breast Feeding
Child*
Chronic Disease
Compliance
Diagnosis*
Ferritins
Hemorrhage
Humans
Infant, Low Birth Weight
Infant, Newborn
Iron
Iron, Dietary
Milk
Nutrition Disorders
Premature Birth
Risk Factors
Thalassemia
Ferritins
Iron
Iron, Dietary

Reference

1. Lerner NB, Sills R. Iron-deficiency anemia. In : Kliegman RM, Stanton BF, St. Geme JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia: Elsevier;2011. p. 1655–1658.

2. Domellof M, Braegger C, Campoy C, Colomb V, Decsi T, Fewtrell M, Hojsak I, Mihatsch W, Molgaard C, Shamir R, Turck D, van Goudoever J. ESPGHAN Committee on Nutrition. Iron requirements of infants and toddlers. J Pediatr Gastroenterol Nutr. 2014; 58:119–129.

3. Lee JO, Lee JH, Ahn S, Kim JW, Chang H, Kim YJ, Lee KW, Kim JH, Bang SM, Lee JS. Prevalence and risk factors for iron deficiency anemia in the Korean population: results of the fifth Korea National Health and Nutrition Examination Survey. J Korean Med Sci. 2014; 29:224–229.

4. Yang YJ, Kim SK, Hong YJ, Kim JG, Hyon IY, Hong KS, Son BK. The prevalence of iron deficiency in preschool children. Korean J Pediatr Hematol Oncol. 1998; 5:14–20.

5. Lanzkowsky P. Iron-deficiency anemia. In : Lanzkowsky P, Lipton JM, Fish JD, editors. Lanzkowsky's manual of pediatric hematology and oncology. 6th ed. London: Academic Press;2016. p. 69–83.

6. Lim JY. Iron deficiency anemia in infants and young children. Clin Pediatr Hematol Oncol. 2014; 21:47–51.

7. Kim SY, Cho B. Helicobacter pylori infection and hematologic diseases. Korean J Helicobacter Up Gastrointest Res. 2013; 13:214–219.

8. Kim CG. Helicobacter pylori and hematologic diseases. Korean J Med. 2013; 84:769–773.

9. 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.

10. Baker RD, Greer FR;. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010; 126:1040–1050.

11. Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf AW. Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics. 2000; 105:E51.

12. World Health Organization. Iron deficiency anaemia: assessment, prevention and control. A guide for programme managers [Internet]. Geneva: World Health Organization;2001. cited 2016 Aug 18. Available from: http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/WHO_NHD_01.3/en/index.html.

13. Jung HL. A new paradigm in the diagnosis of hereditary hemolytic anemia. Blood Res. 2013; 48:237–239.

14. Crary SE, Hall K, Buchanan GR. Intravenous iron sucrose for children with iron deficiency failing to respond to oral iron therapy. Pediatr Blood Cancer. 2011; 56:615–619.

15. Lee JW, Kim DH, Lee JE, Kim SK. Intravenous iron sucrose for three children with iron deficiency anemia failing to respond to oral iron therapy. Clin Pediatr Hematol Oncol. 2013; 20:51–54.