Surico G, Muggeo P, Muggeo V, Lucarelli A, Martucci T, Daniele M, Rigillo N
Department of Pediatric Hematology and Oncology, II Pediatric Clinic, University of Bari, Piazza Giulio Cesare, 70124 Bari, Italy.
Ann Hematol. 2002 Mar;81(3):154-7. doi: 10.1007/s00277-001-0418-3. Epub 2002 Feb 9.
Iron-deficiency anemia impairs growth and intellectual development in children, which can be reversed only by early diagnosis and iron supplementation. Oral supplementation can efficiently replace stores, but in many cases parenteral iron is needed. Unfortunately some adverse reactions have limited its use in children. We compared the efficacy and safety of intramuscular and intravenous administration in 33 evaluable children with severe iron deficiency and/or iron-deficiency anemia who failed to respond to oral iron supplementation. Nineteen children received intravenous infusion and 14 intramuscular injections. All children showed recovery from iron-deficiency anemia, with statistically similar improvement in hemoglobin levels. The duration of treatment was longer in those receiving intramuscular injection. Parenteral iron therapy for the treatment of iron-deficiency anemia is a rapid, easy, and definitive solution to a long-troubling situation. We suggest the use of parenteral iron, in particular intravenous iron, in children who do not recover from severe iron-deficiency anemia after oral therapy. We should consider the physical and neuropsychological sequelae of long-lasting iron deficiency in children and the fact that oral supplementation is less likely to replace iron stores.
缺铁性贫血会损害儿童的生长发育和智力发展，只有通过早期诊断和补充铁剂才能逆转。口服补充剂可以有效地补充铁储备，但在许多情况下需要注射铁剂。不幸的是，一些不良反应限制了其在儿童中的使用。我们比较了33例对口服铁补充剂无反应的重度缺铁和/或缺铁性贫血患儿肌肉注射和静脉注射的疗效和安全性。19名儿童接受静脉输注，14名接受肌肉注射。所有儿童的缺铁性贫血均得到缓解，血红蛋白水平的改善在统计学上相似。接受肌肉注射的儿童治疗时间更长。注射铁剂治疗缺铁性贫血是一种快速、简便且能彻底解决长期困扰问题的方法。我们建议，对于口服治疗后仍未从重度缺铁性贫血中恢复的儿童，应使用注射铁剂，尤其是静脉注射铁剂。我们应考虑儿童长期缺铁的身体和神经心理后遗症，以及口服补充剂不太可能补充铁储备这一事实。
