ABSTRACT
Objective:
Iron deficiency anemia (IDA) is a common disease of childhood encountered in pediatric clinics. Its diagnosis and treatment are quite important in childhood when the growth and development are fast and the requirements are increased. In this study, our objective was to investigate the incidence of iron deficiency anemia, which might be overlooked in children hospitalized in the pediatric clinic.
Methods:
The incidence was prospectively determined with the help of whole blood count, which was evaluated according to the age of patients. The hemoglobin, iron and MCV
levels of patients were evaluated and low levels according to the age and increased iron-binding capacity were considered as significant regarding IDA. The Mentzer index was used
for differential diagnosis. Since ferritin is also an acute-phase reactant, it is taken into consideration as an adjuvant parameter for the diagnosis. The patients with iron deficiency
anemia were determined while other anemia causes were excluded.
Results:
A total of 103 patients 40 females (38.8%) and 63 males (61.2%), who were hospitalized between January 2018 and April 2018 in the Pediatric Clinic of Bahçelievler State Hospital, were included in the study. The ages of children were between 1 and 166 months with an average of 24.2±34.7 months. A total of 17 patients (16.5%) were diagnosed with IDA considering the low hemoglobin, iron and MCV levels and increased iron-binding capacity.
Conclusion:
Iron deficiency anemia is still an important health problem for our country. The nutrition should be properly regulated and the importance of the education of mothers should be emphasized in the 0-14 age group, in which there are rapid growth and development and the requirements are increased. Patients hospitalized for any reason should be evaluated for anemia and iron replacement therapy should be initiated in cases diagnosed with iron deficiency anemia.
Keywords:
Iron deficiency anemia, pediatrics, child
References
1World Health Organization. Iron deficiency anaemia assessment, prevention, and control. A guide for programme managers. Geneva (Switzerland): World Health Organization; 2001:114.
2Çetin E. İstanbul’da yaşayan çocuk ve adolesanlarda anemi prevelansının araştırılması (Tez). İstanbul Üniversitesi Tıp Fakültesi, 1997.
3Gür E, Yildiz I, Celkan T, Can G, Akkus S, Arvas A, et al. Prevalence of anemia and the risk factors among school children in İstanbul. J Trop Pediatr 2005;51:346-50.
4World Health Organization. Iron deficiency: Indicators for Assessment and Strategies for Prevention. Geneva, Switzerland: World Health Organization; 1997.
5Carter RC, Jacobson JL, Burden MJ, Armony-Sivan R, Dodge NC, Angelilli ML, et al. Iron deficiency anemia and cognitive function in infancy. Pediatrics 2010;126:e427-34.
6Karabiber H, Özgen Ü, Özcan C, Soylu H, Kutlu O, Sarıbaş S, et al. Demir eksikliği anemili çocuklarda tedavinin mental skor ve uyarılmış potansiyellere etkisi. UHOD 2000;10:194-8.
7Yurdakök K, İnce OT. Çocuklarda demir eksikliği anemisini önleme yaklaşımları. Çocuk Sağlığı ve Hastalıkları Dergisi 2009;52:224-31.
8Lanzkowsky P. Manual of pediatric hematology and oncology, 4th Edition. London, UK: Elsevier Academic Press, 2005.
9Galloway R, McGuire J. Determinants of compliance with iron supplementation: supplies, side effects, or psychology? Soc Sci Med 1994;39:381-90.
10Pala E, Erguven M, Guven S, Erdogan M, Balta T. Psychomotor development in children with iron deficiency and iron-deficiency anemia. Food Nutr Bull 2010:31:431-5.
11Eroğlu Y, Hiçsönmez G. Hacettepe Üniversitesi Çocuk Hastanesinde anemi sıklığı. Çocuk Sağ Hast Derg 1994;37:267-72.
12Vatandaş NŞ, Tarcan A, Özbek N, Gürakan B. Altı aylık çocuklarda beslenme şekli ile hemoglobin düzeyi ilişkisi. Çocuk Sağlığı ve Hastalıkları Dergisi 2005;48:221-5.
13Friel JK, Aziz K, Andrews WL, Harding SV, Courage ML Adams RJ. A double-masked randomise control of iron supplementation in early infancy in healthy term breast-fed infants. J Pediatr 2003;143:582-6.
14Stevens D. Epidemiology of hypochromic anemia in young children. Arch Dis Child 1991;66:886-9.
15Oski FA. The nonhematologic manifestations of iron deficiency. Am J Dis Child 1979;133:315-22.
16Akman M, Cebeci D, Okur V, Angin H, Abali O, Akman AC. The effects of iron deficiency on infants’Developmental test performance. Acta Paediatr 2004;93:1391-6.
17Erikson KM, Jones BC, Hess EJ, Zhang Q, Beard JL. Iron deficiency decreases dopamine D1 and D2 receptors in rat brain. Pharmacol Biochem Behav 2001;69:409-18.
18Beard JL. Iron biology in immune function, muscle metabolism and neuronal Functioning. J Nutr 2001;131:568S-79S.
19Lozoff B, Klein NK, Nelson EC, McClish DK, Manuel M, Chacon ME. Behavior of infants with iron deficiency anemia. Child Dev 1998;69:24-36.
20Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf AW. Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics 2000;105:E51.
21Idro R, Gwer S, Williams TN, Otieno T, Uyoga S, Fegan G, et al. Iron deficiency and acute seizures: results from children living in rural Kenya and a meta-analysis. PLoS One 2010;16:e14001.
22Özdemir N. Iron deficiency anemia from diagnosis to treatment in children. Turk Pediatri Ars 2015;50:11-9.
23Idro R, Gwer S, Williams TN, Otieno T, Uyoga S, Fegan G, et al. Iron deficiency and acute seizures: results from children living in rural Kenya and a meta-analysis. PloS One 2010;5:e14001.
24Kig D, King A. Question 2: Should children who have a febrile seizure be screened for iron deficiency? Arch Dis Child 2014;99:960-4.