J Pediatr Pharmacol Ther. 2016 Mar-Apr;21(2):162-8. doi: 10.5863/1551-6776-21.2.162.
Response of Iron Deficiency Anemia to Intravenous Iron Sucrose in Pediatric Inflammatory Bowel Disease.
The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG
Istvan Danko
Affiliations
Affiliations
- Department of Pediatrics, Division of Gastroenterology Hepatology and Nutrition, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin.
PMID: 27199624
PMCID: PMC4869774 DOI: 10.5863/1551-6776-21.2.162
Abstract
OBJECTIVES: The objective of this retrospective study was to evaluate the safety and efficacy of intravenous iron sucrose (IS) in iron deficient children with inflammatory bowel disease (IBD) in remission.
METHODS: Electronic medical records at a university based pediatric children's hospital were searched for patients in age range 0 to 18 years with diagnosis of IBD and treatment with IS over a 1-year period. Response to IS treatment was assessed by posttreatment changes in ferritin, hemoglobin (Hb), and mean corpuscular volume (MCV). Patients with recorded symptoms of active disease were excluded from analysis of treatment response.
RESULTS: Twelve patients were identified by the search criteria, 10 with Crohn's disease (CD), 2 with ulcerative colitis (UC). Data represent 8 patients in remission, 7 with CD and 1 with UC, who received a total of 34 IS infusions. Iron sucrose was administered in cycles of 2 infusions, 2.5 to 3.5 mg/kg/dose (maximum 200 mg), 1 week apart. Mean ferritin increased from 21.4 ± 9.2 to 52.9 ± 10.1 ng/mL (p = 0.0005), Hb from 10.9 ± 0.4 to 11.3 ± 0.3 g/dL (p = 0.02), and MCV from 76.9 ± 2 to 79.4 ± 2 fl (p = 0.006). Iron sucrose treatment normalized ferritin in 6 of 7, Hb in 2 of 8, and MCV in 2 of 5 patients with low pretreatment levels. No adverse effects were recorded.
CONCLUSIONS: Two IS infusions of 2.5 to 3.5 mg/kg/dose (maximum 200 mg), given 1 week apart normalized ferritin levels in most pediatric IBD patients in remission without adverse effects. Further studies are needed to determine optimal dosing schedules.
Keywords: anemia; inflammatory bowel diseases; iron sucrose; iron-deficiency; pediatrics
References
- J Crohns Colitis. 2012 Jul;6(6):687-91 - PubMed
- Am J Kidney Dis. 2000 Jul;36(1):88-97 - PubMed
- Curr Treat Options Gastroenterol. 2005 Oct;8(5):411-7 - PubMed
- Am J Gastroenterol. 2008 May;103(5):1299-307 - PubMed
- Pediatr Blood Cancer. 2011 Apr;56(4):511-2 - PubMed
- Nat Rev Gastroenterol Hepatol. 2010 Nov;7(11):599-610 - PubMed
- Pediatr Blood Cancer. 2011 Apr;56(4):615-9 - PubMed
- Scand J Gastroenterol. 2004 May;39(5):454-8 - PubMed
- Inflamm Bowel Dis. 2007 Dec;13(12):1545-53 - PubMed
- Acta Paediatr. 2005 Dec;94(12):1738-41 - PubMed
- Am J Gastroenterol. 2005 Nov;100(11):2503-9 - PubMed
- Am J Gastroenterol. 2001 Aug;96(8):2296-8 - PubMed
- Nephrol Dial Transplant. 2001 Jun;16(6):1239-44 - PubMed
- Biometrics. 1984 Sep;40(3):819-25 - PubMed
- Am J Kidney Dis. 2001 Nov;38(5):988-91 - PubMed
- Nephrol Dial Transplant. 2005 Jul;20(7):1443-9 - PubMed
- Pediatr Nephrol. 2007 Nov;22(11):1963-5 - PubMed
- J Pediatr Gastroenterol Nutr. 2002 Mar;34(3):286-90 - PubMed
- Inflamm Bowel Dis. 2012 Mar;18(3):513-9 - PubMed
- Isr Med Assoc J. 2008 May;10(5):335-8 - PubMed
Publication Types