Mantadakis Elpis, Tsouvala Emmanouela, Xanthopoulou Varvara, Chatzimichael Athanassios
Department of Pediatrics, Democritus University of Thrace Faculty of Medicine, University General Hospital of Evros, Alexandroupolis, Thrace, Greece.
World J Pediatr. 2016 Feb;12(1):109-13. doi: 10.1007/s12519-015-0010-x. Epub 2015 Mar 9.
Intravenous iron sucrose is not recommended by its manufacturers for use in children despite extensive safety and efficacy data in adults.
We reviewed the experience of our department between January, 2011 and February, 2014 with the use of intravenous iron sucrose in children ≤14 years of age who failed in oral iron therapy for iron deficiency anemia (IDA).
Twelve children (6 females) aged 1.2-14 years (median age 8.9 years) received at least one dose of intravenous iron sucrose. Ten patients had IDA inadequately treated or non-responsive to oral iron therapy. One patient received therapy for blood transfusion avoidance and one for presumed iron refractory iron deficiency anemia (IRIDA). Iron sucrose infusions were given on alternate days up to three times per week. The number of infusions per patient ranged from 2 to 6 (median, 3), the individual doses from 100 mg to 200 mg (median, 200 mg), and the total doses from 200 mg to 1200 mg (median, 400 mg). Iron sucrose was effective in raising the hemoglobin concentration to normal in all patients with IDA, i.e., from 7.6±2.38 g/dL to 12.4±0.64 g/dL, within 31-42 days after the first infusion. The single patient with IRIDA demonstrated a 1.8 g/dL rise. Injection site disorders in three cases and transient taste perversion in one case were the only side effects.
Intravenous iron sucrose appears to be safe and very effective in children with IDA who do not respond or cannot tolerate oral iron therapy.
尽管静脉注射蔗糖铁在成人中有广泛的安全性和有效性数据,但其制造商不建议在儿童中使用。
我们回顾了2011年1月至2014年2月间,我们科室对14岁及以下缺铁性贫血(IDA)口服铁剂治疗失败的儿童使用静脉注射蔗糖铁的经验。
12名年龄在1.2至14岁(中位年龄8.9岁)的儿童(6名女性)接受了至少一剂静脉注射蔗糖铁。10名患者的IDA未得到充分治疗或对口服铁剂治疗无反应。1名患者接受治疗以避免输血,1名患者因疑似铁难治性缺铁性贫血(IRIDA)接受治疗。蔗糖铁输注隔天进行,每周最多3次。每位患者的输注次数为2至6次(中位值为3次),单次剂量为100毫克至200毫克(中位值为200毫克),总剂量为200毫克至1200毫克(中位值为400毫克)。在首次输注后31至42天内,蔗糖铁能有效将所有IDA患者的血红蛋白浓度提高至正常水平,即从7.6±2.38克/分升降至12.4±0.64克/分升。唯一一名IRIDA患者的血红蛋白浓度升高了1.8克/分升。仅出现3例注射部位不适和1例短暂味觉异常的副作用。
静脉注射蔗糖铁对于那些对口服铁剂治疗无反应或无法耐受的IDA儿童似乎是安全且非常有效的。