Estado nutricional e absorção intestinal de ferro em crianças com doença hepática crônica com e sem colestase

Abstract

To evaluate food intake, occurrence of energy-protein malnutrition and anemia, and intestinal iron absorption in children with chronic liver disease. The study included 25 children with chronic liver disease, 14 with cholestasis and 11 without cholestasis. The age varied between 6.5 months and 12.1 years. Intestinal iron absorption was evaluated by the increment of serum iron one hour after the ingestion of 1 mg/kg of elemental iron and by the response to oral iron therapy. Iron intestinal absorption was compared to a group with iron deficiency anemia (without liver disease). The mean intake of energy and protein in the cholestatic group was higher than in patients without cholestasis. The nutritional deficit was more severe in cholestatic patients, especially with regard to height-for-age and weight-for-age indices. Anemia was found in both cholestatic group (11/14; 78.6%) and noncholestatic group (7/11; 63.6%). The cholestatic group presented lower (p < 0.05) intestinal iron absorption (90.6+/-42.1 microg/dl) than the iron deficiency anemia group (159.6+/-69.9 microg/dl). However, cholestatic patients responded to oral iron therapy. The noncholestatic group showed intestinal iron absorption similar to the iron deficiency anemia group. The cholestatic group showed more severe nutritional deficits. Despite the evidence of lower iron intestinal absorption, cholestatic patients responded to oral iron therapy, probably, due to the coexistence of iron deficiency.