Inpatient management of iron deficiency anemia in pediatric patients with inflammatory bowel disease: A single center experience

K. Manokaran, Jonathan Spaan, Giulio Cataldo, Christopher Lyons, Paul D Mitchell, Tatyana Sare, Lori A Zimmerman, P. Rufo
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Abstract

BACKGROUND Screening for iron deficiency anemia (IDA) is important in managing pediatric patients with inflammatory bowel disease (IBD). Concerns related to adverse reactions may contribute to a reluctance to prescribe intravenous (IV) iron to treat IDA in this population. AIM To track the efficacy and safety of IV iron therapy in treating IDA in pediatric IBD patients admitted to our center. METHODS A longitudinal observational cohort study was performed on 236 consecutive pediatric patients admitted to our tertiary IBD care center between September 2017 and December 2019. 92 patients met study criteria for IDA, of which 57 received IV iron, 17 received oral iron, and 18 were discharged prior to receiving iron therapy. RESULTS Patients treated with IV iron during their hospitalization experienced a significant increase of 1.9 (± 0.2) g/dL in mean (± SE) hemoglobin (Hb) concentration by the first ambulatory follow-up, compared to patients who received oral iron 0.8 (± 0.3) g/dL or no iron 0.8 (± 0.3) g/dL (P = 0.03). One out of 57 (1.8%) patients that received IV iron therapy experienced an adverse reaction. CONCLUSION Our findings demonstrate that treatment with IV iron therapy is safe and efficacious in improving Hb and iron levels in pediatric patients with IDA and active IBD.
儿科炎症性肠病患者缺铁性贫血的住院治疗:单中心经验
背景:缺铁性贫血(IDA)筛查对于管理儿科炎症性肠病(IBD)患者非常重要。由于对不良反应的担忧,人们不愿意用静脉注射(IV)铁剂来治疗这类人群的缺铁性贫血。目的 跟踪本中心收治的小儿 IBD 患者静脉注射铁剂治疗 IDA 的疗效和安全性。方法 在 2017 年 9 月至 2019 年 12 月期间,对我们的三级 IBD 护理中心连续收治的 236 名儿科患者进行了纵向观察队列研究。92 名患者符合 IDA 研究标准,其中 57 人接受了静脉注射铁剂治疗,17 人接受了口服铁剂治疗,18 人在接受铁剂治疗前出院。结果 与口服铁剂 0.8 (± 0.3) g/dL 或未服用铁剂 0.8 (± 0.3) g/dL 的患者相比,住院期间接受静脉注射铁剂治疗的患者在首次门诊随访时平均(± SE)血红蛋白(Hb)浓度显著增加了 1.9 (± 0.2) g/dL(P = 0.03)。在接受静脉注射铁剂治疗的 57 名患者中,有一人(1.8%)出现了不良反应。结论 我们的研究结果表明,静脉注射铁剂治疗对改善患有 IDA 和活动性 IBD 的儿童患者的血红蛋白和铁含量安全有效。
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