PMID- 8002746
OWN - NLM
STAT- MEDLINE
DCOM- 19940712
LR  - 20131121
IS  - 0003-9764 (Print)
IS  - 0003-9764 (Linking)
VI  - 50
IP  - 8
DP  - 1993 Oct
TI  - [Iron deficiency anemia is not always simple].
PG  - 697-9
AB  - BACKGROUND: Malabsorption of oraliron is rare, and more frequently suspected than 
      proved. It could be due to prolonged iron deficiency. CASE REPORTS: Case no. 1: A 
      boy was admitted at the age of 5 months for recurrent bronchitis. His hemoglobin 
      was 8.2 g/dl, mean corpuscular volume (MCV) 60 micron3, mean corpuscular 
      hemoglobin (MCH) 15 ng and mean corpuscular hemoglobin concentration (MCHC) 25 
      gHb/dl. The serum iron was 1 microgram/dl, iron binding capacity (IBC) was 284 
      micrograms/dl and ferritin was 14.9 ng/ml. Dietary iron was inadequate. The 
      patient was given ferrous sulfate but iron deficiency persisted at the ages of 11 
      months and 3 years, probably due to poor compliance. Similar hematologic data 
      (Hb: 6.4 g/dl, MCV 55 micrograms/m3, MCH 13.9 ng, MCHC 24 gHb/dl) were found at 
      the age of 9 years. The patient was then given ferrous sulfate orally as test but 
      the serum iron levels were unchanged during the 4 hours following ingestion. A 
      parenteral iron preparation (iron-dextran, 500 mg) improved the hematologic data. 
      6 months later, a new oral test with ferrous sulfate improved the serum iron 
      level. Case no. 2: A boy with complex congenital cardiopathy was operated on in 
      the neonatal period and given oral iron at the age of 9 months because of anemia 
      with microcytosis and hypochromia. This anemia was still present at 17 months and 
      was associated with normal or high serum ferritin. Electrophoresis of hemoglobin 
      was normal. At the age of 4 yr 5 mo, Hb was 9.7 g/dl, MCV 62.8 micrograms/m3, MCH 
      18.4 ng, iron 16 micrograms/dl and ferritin 94.1 ng/ml. An oral test with ferrous 
      sulfate failed to increase the serum iron. The patient was then given parenteral 
      iron-dextran without benefit, and a second oral test remained ineffective. After 
      a second course of parenteral iron-dextran, Hb was 11.5 g/dl, MCV 74.1 
      micrograms/m3, MCH 23.7 ng while the serum iron remained low (23 micrograms/dl) 
      and ferritin increased to 587 ng/ml. A third oral test with ferrous sulfate was 
      still ineffective, as was a test using 4 mg/kg iron. CONCLUSION: The first 
      patient suffered from iron malabsorption, presumably due to iron deficiency. The 
      second patient could have abnormal metabolism and/or abnormal ferritin.
FAU - Ovaert, C
AU  - Ovaert C
AD  - Service de Pediatrie, Clinique Notre-Dame, Belgique.
FAU - Bachy, A
AU  - Bachy A
LA  - fre
PT  - Case Reports
PT  - English Abstract
PT  - Journal Article
TT  - L'anemie ferriprive n'est pas toujours simple.
PL  - France
TA  - Arch Fr Pediatr
JT  - Archives francaises de pediatrie
JID - 0372421
RN  - E1UOL152H7 (Iron)
SB  - IM
MH  - Anemia, Hypochromic/metabolism/*physiopathology/therapy
MH  - Drug Resistance
MH  - Humans
MH  - Infant
MH  - Iron/metabolism/therapeutic use
MH  - Male
EDAT- 1993/10/01 00:00
MHDA- 1993/10/01 00:01
CRDT- 1993/10/01 00:00
PHST- 1993/10/01 00:00 [pubmed]
PHST- 1993/10/01 00:01 [medline]
PHST- 1993/10/01 00:00 [entrez]
PST - ppublish
SO  - Arch Fr Pediatr. 1993 Oct;50(8):697-9.