Cause Of Iron Deficiency Anemia Research Articles

Severe Unexplained Iron Deficiency Anemia in Children: High Yield of Upper Gastrointestinal Endoscopy Regardless of Gastrointestinal Symptoms.

In this retrospective study spanning 2016 to 2022, we aimed to evaluate the diagnostic utility of upper gastrointestinal endoscopy (UGE) in children under 18 years presenting with severe unexplained iron deficiency anemia (IDA), defined as microcytic anemia of hemoglobin ≤7g/dL with low ferritin levels. Of 106 children hospitalized for severe anemia, 29 had unexplained IDA (mean hemoglobin level of 6.2 [3.2 to 6.9] gr/dL), and 25 of them underwent UGE. The mean age was 10.7 ± 3.9 years, with 76% being female. Ten children (40%) had gastrointestinal (GI) symptoms at presentation. The cause of IDA was found in 18 (72%) of 25 children who underwent UGE, of whom 12 were without GI symptoms. Gastric nodularity, erosions, or polyps were observed in 68%, and gastritis was evident in 72% based on histopathology. Helicobacter pylori was found in 50% of those with gastritis. Follow-up showed normalized hemoglobin levels in 92% of cases, with only 2 children requiring repeat iron therapy. Our findings underscore the importance of incorporating UGE into the diagnostic investigation of severe unexplained IDA in children, irrespective of the presence of GI symptoms.

The Puzzle of Aspirin and Iron Deficiency: The Vital Missing Link of the Iron-Chelating Metabolites.

Acetylsalicylic acid or aspirin is the most commonly used drug in the world and is taken daily by millions of people. There is increasing evidence that chronic administration of low-dose aspirin of about 75-100 mg/day can cause iron deficiency anaemia (IDA) in the absence of major gastric bleeding; this is found in a large number of about 20% otherwise healthy elderly (>65 years) individuals. The mechanisms of the cause of IDA in this category of individuals are still largely unknown. Evidence is presented suggesting that a likely cause of IDA in this category of aspirin users is the chelation activity and increased excretion of iron caused by aspirin chelating metabolites (ACMs). It is estimated that 90% of oral aspirin is metabolized into about 70% of the ACMs salicyluric acid, salicylic acid, 2,5-dihydroxybenzoic acid, and 2,3-dihydroxybenzoic acid. All ACMs have a high affinity for binding iron and ability to mobilize iron from different iron pools, causing an overall net increase in iron excretion and altering iron balance. Interestingly, 2,3-dihydroxybenzoic acid has been previously tested in iron-loaded thalassaemia patients, leading to substantial increases in iron excretion. The daily administration of low-dose aspirin for long-term periods is likely to enhance the overall iron excretion in small increments each time due to the combined iron mobilization effect of the ACM. In particular, IDA is likely to occur mainly in populations such as elderly vegetarian adults with meals low in iron content. Furthermore, IDA may be exacerbated by the combinations of ACM with other dietary components, which can prevent iron absorption and enhance iron excretion. Overall, aspirin is acting as a chelating pro-drug similar to dexrazoxane, and the ACM as combination chelation therapy. Iron balance, pharmacological, and other studies on the interaction of iron and aspirin, as well as ACM, are likely to shed more light on the mechanism of IDA. Similar mechanisms of iron chelation through ACM may also be implicated in patient improvements observed in cancer, neurodegenerative, and other disease categories when treated long-term with daily aspirin. In particular, the role of aspirin and ACM in iron metabolism and free radical pathology includes ferroptosis, and may identify other missing links in the therapeutic effects of aspirin in many more diseases. It is suggested that aspirin is the first non-chelating drug described to cause IDA through its ACM metabolites. The therapeutic, pharmacological, toxicological and other implications of aspirin are incomplete without taking into consideration the iron binding and other effects of the ACM.

Gastric antral ectasia and diaphragmatic hernia: A rare cause of iron deficiency anemia

Gastric antral ectasia and diaphragmatic hernia: A rare cause of iron deficiency anemia

Iron Supplementation of Pregnant Sows to Prevent Iron Deficiency Anemia in Piglets: A Procedure of Questionable Effectiveness.

In pigs, iron deficiency anemia (IDA) is a common disorder that occurs during the early postnatal period, leading to the stunted growth and increased mortality of piglets. The main cause of IDA is low iron stores in the liver of newborn piglets; these stores constitute the main source of iron needed to satisfy the erythropoietic requirements of the piglets in their first weeks of life. Insufficient iron stores in piglets are usually due to the inadequate placental iron transfer from the sow to the fetuses. Therefore, iron supplementation in pregnant sows has been implemented to enhance placental iron transfer and increase iron accumulation in the liver of the fetuses. Over the years, several oral and parenteral approaches have been attempted to supplement sows with various iron preparations, and consequently, to improve piglets' red blood cell indices. However, there is debate with regard to the effectiveness of iron supplementation in pregnant sows for preventing IDA in newborn piglets. Importantly, this procedure should be carried out with caution to avoid iron over-supplementation, which can lead to iron toxicity. This article aims to critically review and evaluate the use of iron supplementation in pregnant sows as a procedure for preventing IDA in piglets.

Diagnostic Yield of Small Bowel Videocapsule Endoscopy in Patients with Iron Deficiency Anemia. A Systematic Review and meta-analysis.

Gastrointestinal (GI) bleeding or malabsorption represents the most frequent aetiologies of iron deficiency anemia (IDA). The cause of IDA remains undetermined in ~10% to 20% of patients undergoing upper and lower GI endoscopies. In this scenario, a small bowel examination with videocapsule endoscopy (VCE) is recommended. We performed a systematic review with meta-analysis to evaluate the diagnostic yield of VCE in patients with IDA without overt bleeding, assessing the prevalence of either any lesion or lesions at high potential of bleeding. A computerized literature search was performed using relevant keywords to identify all the pertinent articles published until March 2023. Twelve studies with a total of 1703 IDA patients (Males: 47%; age range: 19-92y) were included in this systematic review. The diagnostic yield of VCE for overall lesions in the small bowel was 61% (95% CI=44-77; 95 CI=97.2-98.1; I2=97.7%). When analyzing only small bowel lesions likely responsible of IDA, the diagnostic yield was 40% (95% CI=27-53; 95% CI=95.3-97; I2=96.3%). VCE plays a relevant role in the diagnostic work-up of patients with IDA without overt bleeding with a satisfactory diagnostic yield.

Pharmacotherapeutics for iron deficiency anemia in adults

Background: Iron deficiency anemia (IDA) is among the five greatest causes of disability globally. It can have various causes and may develop concurrently with other health issues. Recently, there have been advances in the treatment of IDA associated with various comorbidities.Current Concepts: The causes of IDA include chronic blood loss, inadequate iron absorption, and increased iron demand. Oral iron supplements are primarily recommended for the treatment of IDA. In cases where oral supplements are ineffective or cannot be used, parenteral iron supplements are administered.Discussion and Conclusion: Identifying the underlying reason for IDA is essential for determining the appropriate and effective treatment plan. In adults, it is important to be aware that gastrointestinal malignancies can be detected as a cause of IDA. Ferrous sulfate tablets are primarily recommended as oral supplements for treating IDA. Among the parenteral iron supplements available in South Korea, both iron sucrose and ferric carboxymaltose can be used relatively safely without significant side effects. Recently, ferric carboxymaltose was reported as being effective for treating iron deficiency associated with heart failure, chronic kidney disease, inflammatory bowel disease, and preoperative IDA.

«Арбузный» желудок — редкая причина хронической железодефицитной анемии

Aim. Demonstration of the rare in general medical practice cause of iron deficiency anemia in a patient with acute and chronic blood loss from vascular ectasias of the gastric mucosa. Key points. Iron deficiency anemia is one of the most common diseases in the world. The most common cause of anemia in gastroenterological practice is chronic or acute blood loss. Gastric antral vascular ectasia, or GAVE syndrome, is the cause of 4% nonvariceal bleeding from the upper gastrointestinal tract. Diagnosis of the disease requires careful endoscopic and histological examination to differentiate GAVE from similar changes (e.g. portal hypertensive gastropathy) and to choose the correct treatment ways. The presented clinical case demonstrates the difficulties of diagnosing the disease in a polymorbid patient, refractory to endoscopic treatments. Conclusion. GAVE syndrome is a rare but clinically significant cause of bleeding from the upper gastrointestinal tract. GAVE syndrome may be asymptomatic or accompanied by a clinical picture of anemia or obvious bleeding. Endoscopic treatment using argon plasma coagulation is considered first-line therapy in patients with GAVE syndrome, but most authors confirm the high rate of recurrence of gastrointestinal bleeding after the procedure. The presented clinical case clearly demonstrates a difficult path to the diagnosis of GAVE syndrome, which was finally verified after 7 years of follow-up of a patient with severe, refractory to the therapy iron deficiency anemia, only when a typical endoscopic picture of vascular ectasias in the antrum of the stomach organized in radial bands — the “watermelon” stomach was formed. At the same time, even the use of modern endoscopic treatment methods was not effective. Keywords: iron deficiency anemia, gastrointestinal bleeding, “watermelon” stomach, GAVE syndrome.

Diagnosis and treatment of iron deficiency anemia

The causes of iron deficiency anemia include blood loss, increased demand, insufficient dietary intake, and disorders affecting iron absorption. In certain circumstances, atrophic gastritis, either autoimmune or due to Helicobacter pylori infection, may contribute. On very rare occasions, iron-refractory iron deficiency anemia can develop as a consequence of TMPRSS6 mutations. Iron deficiency anemia is diagnosed by identification of microcytic hypochromic anemia with low serum ferritin levels. In cases of chronic disorders such as chronic kidney disease, chronic heart failure, and chronic inflammatory disorders, the diagnosis may also incorporate transferrin saturation. Treatment of underlying diseases is recommended along with iron supplementation. While oral iron supplements are the first choice, intravenous iron may be considered when oral administration is impractical, iron absorption is impaired, or rapid iron replenishment is necessary. Recently, high-dose intravenous iron formulations became available in Japan, but their use requires caution due to potential risks of allergic reactions, hypophosphatemia/osteomalacia, iron overload, and vascular leakage. Notably, the benefits of high-dose intravenous iron for patients with heart failure and iron deficiency are recognized in the field of cardiology. This article provides an overview, incorporating recent developments in the field of iron deficiency anemia.

Performance Characteristics of Percentage of Hypochromic Red Cells in the Detection of Latent Iron Deficiency in Women with Menometrorrhagia

BACKGROUND
 Menometrorrhagia is a common cause of iron deficiency anemia (IDA) in women of reproductive age group. Latent iron deficiency (LID) is a precursor stage of IDA in which there is evidence of iron deficiency without anemia. LID causes cognitive impairment, impaired immunity and reduced work capacity which can be corrected by iron supplementation. Conventional biochemical and hematological parameters have limitations in the diagnosis of LID. This study was done to assess the performance characteristics of percentage of hypochromic red cells (% HYPO) in the detection of LID in women with menometrorrhagia.
 METHODS
 This study was done on 226 women attending the Gynaecology OP clinic of our institution, of which 183 had menometrorrhagia, and the remaining being controls. After testing for conventional hematological indices and serum ferritin, the subjects were divided into 3 groups: a LID group, an IDA group, and a control group without iron deficiency. ROC curve analysis was performed to assess % HYPO and other conventional hematological parameters in identifying LID.
 RESULTS
 Most hematological indices were within normal ranges in LID population, thus limiting their utility. The AUC for % HYPO in LID population was 0.736 with an optimum cut-off of 8.7 corresponding to a sensitivity and specificity of 62.3 and 76.74 respectively.
 CONCLUSIONS
 % HYPO is a sensitive, specific, fast, cheap, and practical and thus serves as a better predictive marker than conventional biochemical and hematological parameters in the detection of LID.

Iron deficiency anemia in H.pylori pediatric patients and the role of IL-1β

Background Helicobacter pylori infection has long been recognized to be the cause of iron deficiency anemia (IDA). However, the data in this study shows that only some of children infected with Helicobacter pylori developed an IDA. The objective was to analyze the correlation between IL-1β levels with the incidence of IDA in children with Helicobacter pylori infection. Methods The study was a cross-sectional in which subjects with Helicobacter pylori infection were examined for IL-1β levels along with the incidence of IDA. The study was carried out for one full year period, started from January 2022 to January 2023, at the H. Adam Malik Hospital in Medan and its affiliation. The subjects in this study were pediatric patients who experienced abdominal pain and range between the ages of 2-18 years old. The entire samples were taken by using consecutive sampling. Subjects’ blood sampling were extracted for IL-1β examination (ELISA) and diagnostic tests of Iron Deficiency Anemia, while the diagnosis of H. pylori infection was done by endoscopy (CLO) Results The subjects consisted of 52 children in which 26 of them have Helicobacter pylori (+) and of those 26 children, 23 had IDA (prevalence ratio 11.5 (95% CI 3.015-43.864). There were indications that patients with H. pylori infection (+) is 11.5 times more likely to develop IDA. The cut-off point for IL-1β levels based on the freqtableuency of IDA in children with H. pylori infection is ≤ 1.3 pg/mL The sensitivity and specificity value of IL-1β levels in predicting IDA was 87% and 66.7% respectively. The positive and negative predictive value was 95.2% and 40% (respectively) with the accuracy level of 84.6 %. Conclusion There is a significant correlation between Helicobacter pylori infection and IDA. Interleukin-1β levels were significantly higher in children infected with H. pylori (+) in comparison to H. pylori (-).

Ectoparasitosis induced severe anemia: a rare cause of severe iron deficiency anemia

Abstract Introduction/Objective Ectoparasites generally infest human’s head and body. It is primarily asymptomatic, however, it can cause iron deficiency anemia on rare occasions, even in developed countries. Bird mites can feed on the blood of people who live near infested pigeons or other infested animals. Methods/Case Report We present a 53 years old homeless male who lives in the New York City’s streets. He was brought to the emergency department by EMS due to ataxia and not being able to stand. Upon arrival, he was covered with countless small ectoparasites later identified as bird mites according to an exterminator. Decontamination and stabilization of patient was begun. No active bleeding or sign of trauma was identified. Complete blood count (CBC) was performed and hemoglobin (Hb) of 2.2 g/dL with Hematocrit of 9.2 % was confirmed after repeat on a second sample. Mean corpuscular volume (MCV), red blood cell (RBC) count, reticulocyte percent and red cell distribution width (RDW) was 73.3 fl, 1.26 M/uL, 3.3 % and 19.9 % respectively. Iron study was not performed initially. White blood cell and Platelets count were normal. Hemoglobin electrophoresis was negative for hemoglobinopathies. After initial transfusion of 2 packs of RBC, the Hb was 3.4 g/dL. He started to have seizures and was intubated. He was transferred to ICU. Ferritin level was checked after transfusion and was still markedly decreased (10.9 ng/mL). He received 6 packs of RBC in total (within 10 hours) and Hb reached 8.7 g/dL, and 48 hours after intubation he was extubated. The patient discharged himself against medical advice the next day. Results (if a Case Study enter NA) NA Conclusion With increasing homelessness, physicians should be aware that ectoparasitosis: 1) is a rare cause of iron deficiency anemia, and 2) because of the gradual onset of the anemia, rapid correction with a massive transfusion is neither warranted nor advised.

Causes of Iron Deficiency Anemia in Children Less Than 12 Years Old at Cooper University Hospital and Their Response to Intravenous Iron Replacement

Title of project: Causes of iron deficiency anemia in children less than 12 years old at Cooper University Hospital and their response to intravenous iron Background: Iron deficiency anemia (IDA) is the most common type of anemia in children. Even among industrialized countries like the US, IDA affects many children. Serious adverse outcomes can occur in children with IDA including, cognitive and motor neurodevelopmental delays which may be irreversible. While poor oral intake tends to be the focus of screening and preventative measures, additional causes of IDA include malabsorption from gastrointestinal abnormalities, medications that decrease iron absorption, parasitosis, genitourinary loss, and blood loss. Menorrhagia is a common cause of IDA among adolescents. The average age of menarche for adolescent girls is 12.43 years. Therefore, on data evaluation for the cause of IDA among patients aged 1-21, menstrual bleeding was overrepresented. Objective: This sub-analysis of a single center retrospective chart review analyzed the causes of IDA among children less than 12 years of age at Cooper University Hospital and their response to intravenous iron treatment. Methods: Data on all patients 1-12 years old who received intravenous iron infusions at Cooper University Hospital for IDA between 2016 and 2021 was analyzed. Descriptive statistics on the etiology of IDA and paired t-tests comparing pre-infusion hematologic parameters (hemoglobin, RDW, RBC, MCV, iron, ferritin, TIBC, percent saturation) to post-infusion values were conducted. Results: From the 150 patients included in the original study, 26 patients were 12 years of age or younger. The causes of IDA among these patients included inadequate dietary intake (65.4%), inflammatory bowel disease (15.4%), menorrhagia (15.4%) and one patient with factor II deficiency (3.8%). These patients required between one to eleven infusions to return to normal lab values. When comparing pre-infusion to post-final infusion lab values, there was significant improvement in all values (ferritin, iron, hemoglobin, MCV and RBCs) except total iron binding capacity, RDW and percent saturation. Discussion: Inadequate dietary intake was the most common cause of IDA in children less that 12 years old treated at Cooper University Hospital. Other causes included inflammatory bowel disease, menorrhagia and factor II deficiency. In contrast, the most common cause of IDA in children 12 and older was menorrhagia. Childhood food insecurity has been linked to IDA among low-income patients in the United States. Despite food assistance programs and adequate dietary education, patients continue to remain iron deficient. The current first-line therapy at Cooper University Hospital is oral iron supplementation. However, many patients fail the oral iron trial due to non-adherence, children spitting up or refusing to take the medication, and gastrointestinal side effects. Many pediatric patients in our clinic population are on NJ state insurance which requires a failed oral iron therapy trial prior to qualifying for coverage of intravenous iron. Yet, in a previous retrospective study completed in our clinic, intravenous iron has proven to be effective and safe, with fewer side effects and better adherence. For many patients, especially infants and toddlers, intravenous iron may provide a quicker cure for IDA, preventing irreversible neurodevelopmental delays. We propose that treatment with oral iron and intravenous iron should both be considered for first-line therapies and should be a shared decision between parents and providers.

Associated factors in pediatric patients admitted with severe iron-deficiency anemia in the last seven years - the experience of a single pediatric unit.

To study the causes of iron deficiency, laboratory findings and clinical manifestation of infants aged 6-12 months and children aged 1-3 years diagnosed with severe iron-deficiency anemia. We conducted an observational, retrospective single tertiary center study between January 2015 and April 2022, which included 142 children. The control group (patients with no diagnosis of severe iron-deficiency anemia) included 71 patients and the study group (patients diagnosed with severe iron-deficiency anemia) included also 71 patients. Clinical data were retrospectively collected from hospital medical records. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS) 25.0 software. Seventy-one children had hemoglobin <7 g∕dL and low values of ferritin/serum iron (22 infants aged 6-12 months and 49 children aged 1-3 years). In both the study and control groups, the male gender was slightly more prevalent. Mother's age at birth and living standard is significantly lower in the study group. We note a higher frequency of premature births (14.08%) in children identified with anemia compared to control group (8.45%). We found a statistically significant distribution of cow's milk consumption among the two groups (p<0.001). Pearson's correlation test revealed a significant positive correlation, indicating that anemia is directly proportional to cow's milk consumption. The most frequent cause of iron-deficiency anemia in infants and children 1-3 years old was the consumption of cow's milk following incorrect diversification and incomplete prophylaxis of iron-deficiency anemia.

Pathophysiology and management of iron deficiency anaemia in pregnancy: a review.

According to World Health Organization (WHO), iron deficiency anaemia (IDA) is considered the most prevalent nutritional deficiency worldwide, affecting approximately 30% of the global population. While gastrointestinal bleeding and menstruation in women are the primary causes of IDA, insufficient dietary iron intake and reduced iron absorption contribute to the condition. The aim of IDA treatment is to restore iron stores and normalise haemoglobin levels in affected patients. Iron plays a critical role in various cellular mechanisms, including oxygen delivery, electron transport, and enzymatic activity. During pregnancy, the mother's blood volume increases, and the growing foetus requires a significant increase in iron. Iron deficiency during pregnancy is associated with adverse outcomes such as maternal illness, low birth weight, preterm birth, and intrauterine growth restriction. Iron supplementation is commonly used to treat IDA; however, not all patients benefit from this therapy due to factors such as low compliance and ineffectiveness. In the past, IV iron therapy was underutilised due to its unfavourable and occasionally unsafe side effects. Nevertheless, the development of new type II and III iron complexes has improved compliance, tolerability, efficacy, and safety profiles. This article aims to provide an updated overview of the diagnosis and management of IDA during pregnancy. It will discuss the advantages and limitations of oral versus intravenous iron and the pathophysiology, diagnosis, treatment, and overall management of IDA in pregnancy.

Efficacy and Safety of Intravenous Ferric Carboxymaltose Treatment of Iron Deficiency Anaemia in Patients with Corpus Atrophic Gastritis: A Retrospective Study.

Corpus Atrophic Gastritis (CAG) is characterised by iron malabsorption leading to iron deficiency anaemia (IDA), which rarely responds to oral therapy. Ferric carboxymaltose (FCM), shown to be a safe and effective intravenous iron therapy in other diseases, has not been investigated yet in CAG. Thus, we aimed to assess the safety and efficacy of FCM in CAG-related IDA. A retrospective study on 91 patients identified CAG as the only cause of IDA treated with FCM. Twenty-three were excluded for incomplete follow-up. Sixty-eight were evaluated for safety and efficacy, while three were evaluated for safety only due to infusion interruption for side effects. Haemoglobin and iron storage were evaluated pre-infusion (T0), at 4 weeks (T4) and 12 weeks (T12) after infusion. An eventual IDA relapse was analysed. Two cases reported mild side effects. Haemoglobin significantly increased at T4, and T12, reaching +3.1 g/dL. Ferritin increased at T4, decreasing at T12, while transferrin saturation increased progressively until reaching a plateau. IDA relapsed in 55.4% of patients at a mean of 24.6 months. The only factor associated with relapse was female gender [OR (95% CI): 6.6 (1.5-28.6)]. FCM proved to be safe and effective in treating CAG-related IDA, ensuring quick and long-lasting recovery.

Iron Deficiency among a Group Syrian Women: Causes and Treatment

Iron deficiency is one of the most common nutrient deficiencies in the world. The aim of our research was to identify the most common causes of iron deficiency anemia and the associated factors of lifestyle, dietary habits and menstrual cycle.

Hemoglobin Examination and Giving Guava Juice to Pregnant Women in Cibungbulang District, Bogor Regency

According to data from the WHO (World Health Organization), In 2017, an estimated 295,000 maternal deaths of women died during and after pregnancy and childbirth. The Ministry of Health of the Republic of Indonesia (Kemenkes RI) recorded that the number of maternal deaths in Indonesia was 4,627 people in 2020. This number increased by 8.92% from the previous year, 4,197 people. By province, 745 mothers who died were in West Java last year. The proportion reaches 16.1% of the total maternal mortality in the country. Anemia is one of the indirect causes of maternal death due to bleeding. In pregnant women, anemia increases the frequency of complications in pregnancy and childbirth. In general, one of the causes of iron deficiency anemia is insufficient iron intake and inadequate absorption (Widyastuti, 2005). Iron absorption is greatly influenced by the availability of vitamin C in the mother's body. Guava juice is a fruit easily and cheaply obtained by the public. Red guava contains carbohydrates of 12.2 g / 100 gr and fiber of 5.6 g / 100 guava fruit. So, it is hoped that pregnant women will understand their condition during pregnancy after this service. This community service was conducted through demonstrations and practices on 20 pregnant women in Cibungbulang District, Bogor Regency. This activity went well, and pregnant women felt the benefits of this service activity. Pregnant women are expected to be aware of the dangers of anemia and the benefits of detection by checking hemoglobin and consuming guava juice to increase hemoglobin levels.

Experience with the prolonged release of iron in iron deficiency patients

Iron deficiency is one of the leading factors in the global burden of disease, affecting mainly children, premenopausal women and low- and middle-income people. With prolonged iron deficiency, iron deficiency anemia (IDA) develops, which, according to the World Health Organization (WHO), remains the most common type of anemia worldwide. The most common causes of IDA include gastrointestinal bleeding, menstrual blood loss and pregnancy in women. Currently, divalent iron preparations are considered the “gold standard” of IDA therapy. To date, there are preparations of divalent iron with delayed release. The advantage of this form is that such drugs are better tolerated, they have a lower incidence of side effects with comparable bioavailability and efficacy compared to conventional forms. Such drugs include Tardyferon®.In our study, it was noted that against the background of taking Tardyferon®, the level of ferritin by the end of the 1st month of therapy in patients with latent iron deficiency increased from 12.4 ± 0.93 to 27.8 ± 4.1 µg/L (p ≤ 0.05). In patients with IDA, it increased from 9.7 ± 1.3 to 25.4 = 5.1 µg/L. By the end of the 3rd month of treatment, the ferritin level in patients with latent iron deficiency was 200.1 ± 30.8 (p &lt; 0.05), and in patients with IDA – 246.7 µg/L (p &lt; 0.05). We noted a similar dynamic in the hemoglobin level: in patients with IDA, it increased from 97.4 ± 9.3 g/L to 125.8 ± 10.2 g/l (p &lt; 0.05), and in 21 (75%) of 28 patients it reached normal values (more than 120 g/L) by the end of the 1st months of therapy.By the 3rd month of therapy, all patients with IDA had already reached the target level, and the average hemoglobin value in the group was 142.1 ± 5.6 g/L (p = 0.05).Thus, in patients with IDA, against the background of therapy with Tardyferon®, hemogram indicators normalize, the concentration of hemoglobin and ferritin increases by the end of the 1st month of therapy.

10-year-old case report of pediculosis with severe anaemia

Excessive consumption of cow milk and menorrhagia are the two most common causes of iron deficiency anaemia (IDA) in children. However, there have been reported cases of parasitic infestation causing IDA. Pediculus humanus survives on human blood, and prolonged blood loss causes anaemic symptoms. In the current case report, a 10-year-old girl complained of pallor and dizziness. During her physical examination, a head lice infestation was discovered. The patient had no history of chronic illness and used to eat a normal diet that was high in iron. Her haemoglobin level was measured to be 4 g/dl. Doctors determined that the severe iron deficiency was caused due to the head lice infestation. To reach the required haemoglobin level, she was admitted to the hospital and given a blood transfusion. Her head was washed with permethrin 1% shampoo, which removed over 60% of the lice in a single wash. She was instructed to wash her hair with the shampoo again after seven days.

An urgent appeal to paediatric primary caregivers to help prevent severe iron deficiency anemia in toddlers.

Iron deficiency anemia (IDA) is a common problem in toddlers. The cause of IDA is multifactorial but is often from excessive consumption of cow's milk. The prevalence and at times devastating consequences of IDA are under recognized. There are increasing numbers of toddlers presenting with severe IDA. We urge all paediatric primary care givers to help prevent severe IDA through adherence to the 2019 CPS Guidelines on iron requirements, early diagnosis, and adequate treatment.