Severe iron deficiency anemia in 42 pediatric patients

The objective of this study was to determine the clinical and laboratory features of children with severe iron deficiency anemia. The authors retrospectively reviewed the charts of 198 children with iron deficiency anemia to ascertain cases of severe iron deficiency anemia. Forty-two children with severe iron deficiency anemia were evaluated. The median age was 21 months (range, 7-240 months) at diagnosis and 27 children were 13-24 months of age. For 35 children the major source of calories was derived from cow's milk. The median hemoglobin was 4.6 g/dL (range, 2.1-6 g/dL) and the median serum ferritin was 5 μg/L (range, 1-11 μg/L). Twenty-nine received oral iron and 13 required packed red blood cell transfusions because of co-morbid cardiorespiratory distress. Severe iron deficiency anemia mostly affects children during their second year of life. Oral iron therapy is sufficient for most children, but packed red blood cell transfusions may be needed.     

Gastrointestinal smooth muscle tumors and iron deficiency anemia in children

Smooth muscle tumors are rarely seen in the pediatric population. We present a child with smooth muscle tumor of low malignant potential in the ileocecal valve region in whom iron deficiency anemia was the only presenting sign. Abdominal computed tomographic (CT) scan, barium enema, and colonoscopy revealed the mass. Following resection of the tumor the anemia was corrected and the child feels well. Med. Pediatr. Oncol. 28:441–443, 1997. © 1997 Wiley-Liss, Inc.     

106例6个月～6岁儿童缺铁性贫血临床表现及实验室检查分析

目的 探讨6个月～6岁儿童缺铁性贫血（IDA）的发病因素、临床特点、实验室检查并探讨其预防措施.方法 对106例6个月～6岁IDA患儿进行病因调查、查体及血常规、铁蛋白、叶酸、维生素B12等相关检查结果进行分析.结果 轻度贫血51例,中度贫血40例,重度贫血10例,极重度贫血5例.儿童缺铁性贫血与孕产因素、喂养因素等均有较大关系,且农村IDA发病率高于城市.结论 缺铁性贫血目前仍然是儿童期重要的营养缺乏病,应予高度重视,及时发现,尽早干预.     

缺铁性贫血大鼠学习记忆能力的变化及其与脑组织中微量元素的关系

目的　观察缺铁性贫血对大鼠学习记忆能力的影响及其与脑组织中 7种微量元素的关系。方法　应用低铁饮食 (含铁量为 11 9mg/kg的饲料 )建立缺铁性贫血大鼠模型 ,用MG 2型三等分辐射式迷宫检测大鼠的学习记忆能力 ,用三电极等离子体原子发射直读光谱仪测定脑组织中 7种微量元素的含量。结果　缺铁性贫血大鼠在迷宫测验时达标所需反应次数 [(72± 9)次 ]较对照组[(5 0± 9)次 ]显著增加 (P <0 0 1) ;正确反应率 [(5 9± 5 ) % ]较对照组 [(6 6± 9) % ]显著降低 (P <0 0 5 ) ,2 4h后复测仍有相似结果 ,表明缺铁性贫血大鼠学习记忆能力显著降低。脑组织中铁、锌含量[(13 7± 3 5 ) μg/g湿组织、(8 6± 2 1) μg/g湿组织 ]明显低于对照组 [(2 6 1± 2 7) μg/g湿组织、(11 3± 0 9) μg/g湿组织 ,P <0 0 1],锰、镉含量 [(0 5 6± 0 12 ) μg/g湿组织、(0 0 8± 0 0 4) μg/g湿组织 ]明显高于对照组 [(0 46± 0 0 8) μg/g湿组织、(0 0 5± 0 0 1) μg/g湿组织 ,P <0 0 5 ]。 结论　缺铁性贫血大鼠的学习记忆能力降低与其脑组织微量元素的变化有关。     

儿童缺铁性贫血的流行病学研究进展

越来越多的研究表明缺铁性贫血严重危害儿童健康,对儿童认知和精神运动的发育造成不可逆转的损害.虽然我国人民经济生活水平有了极大改善,但儿童缺铁性贫血状况仍不容乐观.该文主要就我国儿童缺铁性贫血的状况、缺铁的危险因素、相应的预防治疗措施等进行综述.     

Problems in diagnosis of iron deficiency anemia

Iron deficiency is the most common nutritional deficiency in children and is widespread in childhood populations throughout the world. Although many sophisticated tests have been devised for the diagnosis of iron deficiency the most reliable criterion of iron deficiency anemia is the hemoglobin response to an adequate therapeutic trial of iron. Following the reticulocytosis peak hemoglobin rises at an average of 0.25 to 0.4 g/dl/day and hematocrit at a rate of 1% per day. If the response to iron falls short of this response other causes of the anemia should be sought by detailed hematologic investigation. In addition to making a diagnosis of iron deficiency anemia it is incumbent on the physician to demonstrate its cause.     

儿童铁缺乏症及缺铁性贫血防治进展

铁是人体必需微量元素中含量最多的一种,膳食中可利用铁长期不足,常可导致铁缺乏(iron deficiency)和缺铁性贫血(iron deficiency anemia,IDA)[1].小儿IDA是机体对铁的摄入不足,需要量增加或铁丢失过多造成机体内贮存铁缺乏,导致血红蛋白合成障碍引起的一种贫血[1].     

缺铁小儿血清转铁蛋白受体变化及其意义

为探讨血清中可溶性转铁蛋白受体（sTfR）在缺铁性贫血诊断中的意义，用单克隆及多克隆双抗体夹心ELISA法测定正常对照组、隐性缺铁组、红细胞生成缺铁组、轻度缺铁性贫血组、中～重度缺铁性贫血组小儿sTfR。结果分别为4．0±1．1、5．3±1.1、7.2±1.2、94±2.6、14.9±5.3mg／L，各组均数比较及两两比较均有显著性差异。分析sTfR及血清铁蛋白（SF）在各组间的动态变化，发现对照组与隐性缺铁组间SF差值最大，sTfR变化则远不及SF；随着缺铁继续加重，SF保持低水平上的相对恒定；sTfR则迅速升高。此结果提示SF是诊断隐性缺铁最敏感的指标，sTfR则为诊断红细胞生成缺铁及缺铁性贫血的可靠指标，并可量度贮存铁耗竭后继续铁缺失的严重程度。     

Reversal of iron deficiency anemia-induced peripheral neuropathy by iron treatment in children with iron deficiency anemia

The effects of iron deficiency anemia (IDA) on nerve conduction and efficiency of iron therapy were investigated by peripheral nerve-electrophysiological measurements. Eighteen children (10 boys, eight girls; mean age 31 +/- 1.3 months) with IDA and 12 healthy children (six boys, six girls; mean age 29 +/- 1.3 months) were enrolled into the study. Nerve conduction velocity was measured in the median and posterior tibial nerve. After nerve conduction values were determined in the patients and controls, 6 mg/kg/24 h ferrous sulphate was given orally to the patients for 3 months and nerve conduction velocity tests were performed again. Median/motor and sensory nerve conduction velocity and tibial/motor nerve distal-amplitute values of children with IDA were lower than for the control group (p < 0.05, p < 0.01 and p < 0.001 respectively). With iron supplementation these values increased to the normal levels and even higher than control levels for some parameters. In correlation studies between whole blood parameters and nerve conduction velocity results, there was a correlation between median/sensory nerve conduction velocity values and serum iron levels. Additionally there was a correlation between some nerve conduction velocity values and age. In conclusion, the evidence from this preliminary study suggests that peripheral neuropathy may develop in children with IDA. Peripheral neuropathy symptoms in these patients may be improved by iron therapy.     

儿童缺铁和缺铁性贫血防治建议

一、前言 铁缺乏症(iron deficiency,ID)是最常见的营养素缺乏症和全球性健康问题,据估计世界1/3人口缺铁.由于健康教育和广泛采用铁强化食品等措施,目前欧美发达国家儿童缺铁性贫血(iron deficiency anemia,IDA)患病率已显著降低[1].     

Microcytic anemia in children: parallel screening for iron deficiency and thalassemia provides a useful opportunity for thalassemia prevention in low- and middle-income countries

Abstract

Microcytic anemia in children is commonly attributed to iron deficiency without attempting to find the cause. Inadequate investigations to exclude hemoglobinopathies lead to missed opportunities for identification of thalassemia carriers. Here we aim to describe the relative contribution of iron deficiency and thalassemia to microcytic anemia in children. This hospital-based prospective study was conducted at the Colombo North Teaching Hospital, Ragama, Sri Lanka. All newly diagnosed patients with microcytic anemia were recruited and data were collected using an interviewer-administered questionnaire. Full blood count, blood film, serum ferritin, c-reactive protein, quantification of hemoglobin sub-types and α-globin genotype were performed using 4?ml of venous blood. A total of 104 children (Male- 60.5%) were recruited. Iron deficiency was the cause for anemia in 49% whilst 16% and 10% had α- and β-thalassemia trait respectively. Seven (6.7%) children had co-existing iron deficiency and thalassemia trait while two coinherited α- and β-thalassemia trait. Children with β-thalassemia trait had significantly higher red cell count and lower mean corpuscular volume compared to children with iron deficiency. However, none of the red cell parameters were significantly different between children with α-thalassemia trait and iron deficiency. Iron deficiency contributes only to half of children with microcytic anemia; one-fourth had thalassemia trait. Co-existence of iron deficiency and thalassemia trait or co-inheritance of α- and β-thalassemia trait were found in 9%. Parallel investigation of children with microcytic anemia to diagnose iron deficiency and thalassemia provides an opportunity to identify thalassemia carriers which is beneficial for thalassemia prevention.