[Anemia and iron deficiency in children with chronic respiratory diseases].

INTRODUCTION

Children with chronic respiratory disease (CRD) are at increased risk of iron deficiency and anemia, which is under-diagnosed.

AIM: To describe the iron (Fe) status in children with CRD and to evaluate the effects of its prophylactic indication.

METHOD: Prospective study of children with CRD and adequate Fe intake in the diet. At baseline we measured hemogram, C-reactive protein and Fe profile. Subsequently, those with normal plasma hemoglobin (Hb) were not supplemented with Fe (Group A) and those with iron deficiency anemia or at risk of developing it (group B) were supplemented. We evaluated them 3 months later and, after supplementing all, at 4th month.

RESULTS

Of 40 patients, median 30 months old (0.5 to 178), 60% were male, 80% eutrophic. Ventilation or oxygen were required in 45%. Diagnoses: 50% Chronic Lung Damage, 17.5% airway diseases, 10% Bronchopulmonary Dysplasia, 7.5% Cystic Fibrosis and 13.5% other. At baseline 20% were anemic (mostly ferropenic) and 12.5% had an abnormal iron profile. At all, 25 children completed the study: in group A, serum ferritin decreased to 3(th) month (-22.9 ± 30) and incremented to 4(th)month (+12.8 ± 26) μg/L (p = 0.013), without difference in Hb. Group B had a rise in Hb (91 ± 12 to 102 ± 12% of the mean for age, p = 0.04).

CONCLUSION

Anemia and ferropenia are frequent in children with CRD. Decrease of their iron reserves can be prevented if they are supplemented. We suggest monitoring properly and treating early or supplement them prophylactically.