title: Pediatric Crohn's disease, iron deficiency anemia and intravenous iron treatment: a follow-up study.
abstract: OBJECTIVE
  Increasing evidence in adults demonstrates efficacy and safety of IV iron in inflammatory Bowel disease (IBD) associated iron deficiency anemia; however, evidence in pediatric patients is yet scarce and no previous study has included a long follow-up. This study aimed to evaluate safety and efficacy of IV iron (primary end point), and the need of re-treatment (secondary end point), in this setting.
  
  
  METHODS
  Prospective recruitment (40 months); PCDAI determined before and after treatment; anemia defined according to WHO criteria; IV iron treatment included iron sucrose and ferric carboxymaltose. Primary and secondary endpoints included hemoglobin, serum ferritin, transferrin saturation at baseline and 4-6 weeks after treatment; and the need of re-treatment during the median follow-up period (18 months), respectively.
  
  
  RESULTS
  Nineteen patients (median age: 15.5 years) with remissive/mild disease were included. At recruitment, the median hemoglobin was 10.5 g/dl, (median s-ferritin: 20.1 ug/l, median transferrin saturation; 6%) and 4-6 weeks after treatment was 12.7 g/dl. Median hemoglobin according to age groups before vs. after treatment: <12 years:11 vs. 12.0 g/dl; females ≥12 years:9.9 vs. 12.6 g/dl; and males ≥12 years:11.1 vs. 13.3 g/dl. Patients with remissive vs. mild disease had median Hb of 10.5 g/dl vs. 10.6 g/dl, and median s-ferritin: 6.8 ug/dl vs. 43.3 ug/dl, respectively). Nine patients were treated with iron sucrose (median dose 672.6 mg/dl) and 10 patients with ferric carboxymaltose (median dose 811.5 mg/dl). No major adverse reactions occurred. Six patients needed re-treatment after a median 15.5 months period.
  
  
  CONCLUSIONS
  Our prospective study, concerning pediatric IBD anemia patients with remission/mild disease and a significant follow-up, emphasizes efficacy and safety of IV-iron and the importance of long-term follow-up of iron status.
  
  
  CONCLUSIONS
  In pediatric IBD iron anemia, the evidence supporting the efficacy and safety of IV-iron is scare. This prospective study aims to evaluate the safety and efficacy (short and long term) of IV-iron in these patients. Nineteen pediatric CD patients were evaluated before and after IV iron treatment (40-month period).The median Hb before and after IV iron was 10.5 and 12.7 g/dl, respectively. No major adverse reactions were documented. Six patients needed re-treatment (median period of 15.5 months). This study further demonstrates the efficacy and safety of IV iron. It reinforces the importance of long-term follow-up of the iron status in pediatric CD patients.
authors: a Department of Pediatrics, Pediatric Gastroenterology Unit, Faculty of Medicine of Lisbon , Santa Maria University Hospital, Lisbon Academic Medical Centre , Lisbon , Portugal.
authors: Sara
authors: S
authors: Valério de Azevedo
authors: a Department of Pediatrics, Pediatric Gastroenterology Unit, Faculty of Medicine of Lisbon , Santa Maria University Hospital, Lisbon Academic Medical Centre , Lisbon , Portugal.
authors: Catarina
authors: C
authors: Maltez
authors: a Department of Pediatrics, Pediatric Gastroenterology Unit, Faculty of Medicine of Lisbon , Santa Maria University Hospital, Lisbon Academic Medical Centre , Lisbon , Portugal.
authors: Ana Isabel
authors: AI
authors: Lopes
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy*; D002648:Child; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D000077605:Ferric Oxide, Saccharated; D005293:Ferritins / Q000097:blood; D005500:Follow-Up Studies; D005937:Glucaric Acid / Q000008:administration & dosage*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008320:Maltose / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011174:Portugal; D011446:Prospective Studies; D014168:Transferrin / Q000032:analysis
chemical_list: D005290:Ferric Compounds; D006454:Hemoglobins; D014168:Transferrin; C522335:ferric carboxymaltose; D008320:Maltose; D005293:Ferritins; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid
keywords: Pediatric Crohn’s disease; intravenous iron; iron deficiency anemia