Iron deficiency in children with a focus on inflammatory conditions.

IF 3.2 Q1 PEDIATRICS
Clinical and Experimental Pediatrics Pub Date : 2024-06-01 Epub Date: 2024-05-21 DOI:10.3345/cep.2023.00521
Na Hee Lee
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Abstract

Iron deficiency (ID) tends to be overlooked compared with anemia. However, its prevalence is estimated to be twice as high as that of ID anemia, and ID without anemia can be accompanied by clinical and functional impairments. The symptoms of ID are nonspecific, such as fatigue and lethargy, but can lead to neurodevelopmental disorders in children, restless legs syndrome, and recurrent infections due to immune system dysregulation. In particular, the risk of ID is high in the context of chronic inflammatory diseases (CIDs) due to the reaction of various cytokines and the resulting increase in hepcidin levels; ID further exacerbates these diseases and increases mortality. Therefore, the diagnosis of ID should not be overlooked through ID screening especially in high-risk groups. Ferritin and transferrin saturation levels are the primary laboratory parameters used to diagnose ID. However, as ferritin levels respond to inflammation, the diagnostic criteria differ among guidelines. Therefore, new tools and criteria for accurately diagnosing ID should be developed. Treatment can be initiated only with an accurate diagnosis. Oral iron is typically the first-line treatment for ID; however, the efficacy and safety of intravenous iron have recently been recognized. Symptoms improve quickly after treatment, and the prognosis of accompanying diseases can also be improved. This review highlights the need to improve global awareness of ID diagnosis and treatment, even in the absence of anemia, to improve the quality of life of affected children, especially those with CIDs.

以炎症为重点的儿童铁缺乏症。
与贫血相比,铁缺乏症(ID)往往被忽视。然而,据估计,缺铁性贫血的发病率是缺铁性贫血的两倍,而且不伴有贫血的缺铁性贫血还可能伴有临床和功能障碍。ID 的症状无特异性,如疲倦和嗜睡,但可导致儿童神经发育障碍、不安腿综合征,以及因免疫系统失调而引起的反复感染。特别是在慢性炎症性疾病(CIDs)的情况下,由于各种细胞因子的反应以及由此导致的血磷脂水平升高,ID 的风险很高;ID 会进一步加重这些疾病,并增加死亡率。因此,通过 ID 筛查不应忽视 ID 的诊断,尤其是在高危人群中。铁蛋白和转铁蛋白饱和度是诊断 ID 的主要实验室指标。然而,由于铁蛋白水平会对炎症做出反应,不同指南的诊断标准也不尽相同。因此,应开发新的工具和标准来准确诊断 ID。只有在得到准确诊断后才能开始治疗。口服铁剂通常是治疗 ID 的一线疗法;然而,静脉注射铁剂的有效性和安全性最近已得到认可。治疗后症状会很快改善,伴随疾病的预后也会得到改善。本综述强调,即使在没有贫血的情况下,也有必要提高全球对 ID 诊断和治疗的认识,以改善患儿的生活质量,尤其是 CID 患儿的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.00
自引率
2.40%
发文量
88
审稿时长
60 weeks
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