Division of Pulmonary and Sleep Medicine, Children's Mercy Hospital, Kansas City, Missouri.
Division of Pulmonary and Sleep Medicine, Seattle Children's Hospital, Seattle, Washington.
J Clin Sleep Med. 2022 Nov 1;18(11):2545-2551. doi: 10.5664/jcsm.10152.
Initial reports of intravenous (IV) iron administration have been promising for children with restless legs syndrome, periodic limb movement disorder, and restless sleep disorder. The aim of the current study was to evaluate further the clinical response to IV iron supplementation in children seen in a pediatric sleep clinic.
We performed a retrospective chart review of children cared for in a single pediatric sleep clinic who also underwent IV iron infusion. Pre and post IV data regarding their sleep symptoms and ferritin levels were abstracted.
Overall, 63 pediatric sleep patients underwent IV iron infusion, mostly with ferric carboxymaltose (n = 60), for restless legs syndrome (n = 30), periodic limb movement disorder (n = 22), and restless sleep disorder (n = 17). Of the 59 patients with clinical follow-up, 39 (73%) noted improvement in at least 1 symptom, and 14 (26%) did not notice improvement or noticed worsening symptoms. Of the 59 patients with preinfusion and postinfusion labs, the average ferritin level increased from 21.7 (13.3) to 147.9 (120.9) μg/L, < .001. Comparing patients who experienced clinical improvement vs those who did not, there were no statistically significant differences in change in ferritin levels ( = .278), sex ( = .452), or age ( = .391). Ferritin change with infusion according to diagnostic subgroups (restless legs syndrome/periodic limb movement disorder/restless sleep disorder) was examined, and no significant differences were noted ((2,56) = 0.852, = .432). In terms of immediate adverse reactions to the IV infusion, 7 (11%) experienced at least 1 side effect, with the most common being behavior change (n = 6) or gastrointestinal discomfort (n = 4); no episodes of anaphylaxis or extravasation were noted.
These data provide additional support for the efficacy and safety of IV iron for pediatric restless legs syndrome, periodic limb movement disorder, and restless sleep disorder recalcitrant to oral iron.
Ingram DG, Al-Shawwa B, DelRosso LM, Sharma M. Intravenous iron therapy in the pediatric sleep clinic: a single institution experience. . 2022;18(11):2545-2551.
静脉（IV）铁剂治疗不宁腿综合征、周期性肢体运动障碍和不安腿睡眠障碍儿童的初步报告令人鼓舞。本研究的目的是进一步评估在儿科睡眠诊所就诊的儿童中接受 IV 铁补充的临床反应。
我们对在单一儿科睡眠诊所接受治疗并接受 IV 铁输注的儿童进行了回顾性图表审查。提取 IV 前后有关睡眠症状和铁蛋白水平的数据。
总体而言，63 名儿科睡眠患者接受了 IV 铁输注，主要是使用羧基麦芽糖铁（n = 60），用于治疗不宁腿综合征（n = 30）、周期性肢体运动障碍（n = 22）和不安腿睡眠障碍（n = 17）。在有临床随访的 59 名患者中，39 名（73%）至少有 1 种症状改善，14 名（26%）未注意到改善或注意到症状恶化。在有输注前和输注后实验室检查的 59 名患者中，铁蛋白水平从 21.7（13.3）升高至 147.9（120.9）μg/L，<0.001。比较临床改善的患者和未改善的患者，铁蛋白水平的变化无统计学差异（=0.278），性别（=0.452）或年龄（=0.391）。根据诊断亚组（不宁腿综合征/周期性肢体运动障碍/不安腿睡眠障碍）检查输注时的铁蛋白变化，未发现显著差异（（2,56）=0.852，=0.432）。就 IV 输注的即时不良反应而言，7 名（11%）患者至少出现 1 种副作用，最常见的是行为改变（n = 6）或胃肠道不适（n = 4）；未发生过敏反应或外渗。
这些数据为 IV 铁治疗儿童不宁腿综合征、周期性肢体运动障碍和口服铁治疗无效的不安腿睡眠障碍的疗效和安全性提供了额外支持。
Ingram DG，Al-Shawwa B，DelRosso LM，Sharma M。儿科睡眠诊所的静脉铁治疗：单机构经验。. 2022；18（11）：2545-2551。
