title: Response to parenteral iron therapy distinguish unexplained refractory iron deficiency anemia from iron-refractory iron deficiency anemia.
abstract: BACKGROUND
  We evaluated that response to parenteral iron therapy could be helpful in distinguishing the types of iron deficiency anemia.
  
  
  METHODS
  This study analyzed responses to IV iron sucrose therapy of 15 children with unexplained refractory iron deficiency anemia (URIDA). We compared the results at diagnosis, 6 weeks and 6 months after the therapy. Results were compared with responses of 11 patients' results with iron-refractory iron deficiency anemia (IRIDA) from our previous study.
  
  
  RESULTS
  Six weeks after the start of treatment, ferritin, MCV, MCH and Hb values were in normal range in 10 patients. The increase in Hb, MCH, MCV, and ferritin values ranged 2.6-3.5 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. In five patients, Hb, MCH, and MCV mean (range) values [11.2 g/dL (11-12.2), 24.5 pg (24-25.6), and 67 fL (65-70)] were nearly normal but ferritin mean (range) values [9.8 ng/mL (8-11)] were below normal. Six weeks after the start of treatment, Hb, MCH, MCV and ferritin values of patients with IRIDA were increased. The increase in Hb, MCH, MCV, and ferritin values ranged 0.8-2.7 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. IRIDA is only partially responsive to parenteral iron supplementation. In conclusion, this study demonstrated that the response to intravenous iron therapy for the URIDA cases improved blood parameters more effectively than hereditary IRIDA. Response to parenteral iron therapy would be helpful to distinguish unexplained refractory IDA from hereditary IRIDA for clinicians who do not have access to hepcidin or TMPRS6 mutation analysis.
authors.affiliation: Department of Pediatric Hematology, Pamukkale University, Denizli, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Akin
authors.affiliation: Department of Pediatric Hematology, Pamukkale University, Denizli, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Sarbay
authors.affiliation: Department of Pediatric Hematology, Pamukkale University, Denizli, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Guler
authors.affiliation: Department of Pediatric Hematology, Pamukkale University, Denizli, Turkey.
authors.forename: Y I
authors.initials: YI
authors.lastname: Balci
authors.affiliation: Department of Pediatric Hematology, Pamukkale University, Denizli, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Polat
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D007501:Iron / Q000008:administration & dosage*; D008297:Male; D010288:Parenteral Nutrition; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007501:Iron
keywords: Anemia; IDA; IRIDA; refractory