Tolerance and efficacy of intravenous iron saccharate for iron deficiency anemia in children and adolescents receiving long-term parenteral nutrition

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 21; no. 5; pp. 403 - 407
• Main Authors: MICHAUD, L., GUIMBER, D., MENTION, K., NEUVILLE, S., FROGER, H., GOTTRAND, F., TURCK, D.
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.10.2002; Elsevier
• Subjects: Adolescent; anemia; Anemia, Iron-Deficiency - blood; Anemia, Iron-Deficiency - drug therapy; Anemias. Hemoglobinopathies; Biological and medical sciences; blood transfusion; Child; Child, Preschool; children; Diseases of red blood cells; Erythrocyte Indices - drug effects; Ferric Compounds - administration & dosage; Ferric Compounds - adverse effects; Ferric Compounds - blood; Ferritins - blood; Glucaric Acid; Hematologic and hematopoietic diseases; Hemoglobins - drug effects; Humans; Infant; Infusions, Intravenous; intravenous; Iron - blood; iron deficiency; Medical sciences; Metabolic diseases; Metals (hemochromatosis...); Other metabolic disorders; parenteral nutrition; Parenteral Nutrition - adverse effects; Reticulocyte Count; Time Factors; blood transfusion; intravenous; iron deficiency; parenteral nutrition; children; anemia; Human; Intravenous administration; Iron deficiency anemia; Treatment efficiency; Tolerance; Hemopathy; Iron; Long term; Parenteral administration; Feeding; Chemotherapy; Treatment; Adolescent; Complication; Sideropenia; Child
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1054/clnu.2002.0567

The aim of this study was to evaluate the safety and efficacy of intravenous iron saccharate administration in iron-deficient anemic children, under long-term parenteral nutrition, who are unable to tolerate oral iron supplementation or are unresponsive to oral supplementation because of gastrointestinal dysfunction or iron malabsorption. Methods: Twenty-two infants and children aged 5 months–17 years (median: 38 months) receiving long-term parenteral nutrition and presenting with iron deficiency anemia were included. Total iron to be infused was determined by the formula: total iron (mg) = 0.6× W (100 − Hb×100/12) ( W: weight, Hb: hemoglobin). Intravenous iron saccharate was given at the hospital. Each patient received a test dose of 25 mg of iron saccharate prior to the initiation of the infusion. Hemoglobin values, reticulocytes count, serum iron, and serum ferritin were determined before iron administration (day 1), as well as 15 and 45 days after iron administration. Results: Tolerance of intravenous iron saccharate was good except in one patient who developed transient exanthema and hypotension after completion of the last iron saccharate infusion. Intravenous iron led to a significative increase in hemoglobin concentration of 2.2 g/dl within 45 days (range: 0.4–4.3 g/dl). Conculsion: Intravenous iron supplementation with iron saccharate is an efficient procedure, replenishing iron body stores and significantly increasing the hemoglobin concentration. The possible occurrence of allergic reactions emphasizes the need for close medical supervision.