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Expert: Iron deficiency may affect more of your patients than you realize

August 30, 2021












Editor's note:For more coverage of the 2021 AAP National Conference & Exhibition, visithttps://www.aappublications.org/news/2021/08/18/nationalconference2021.

Jacquelyn M. Powers, M.D., M.S., FAAP, will present “Iron Deficiency: Update on Screening, Diagnosis, and Treatment” from 2:30-3:30 p.m. CDT Saturday. The session will be livestreamed and recorded for attendees to view later.

Dr. Powers is director of the Iron Disorders and Nutritional Anemias Program within the Texas Children’s Cancer and Hematology Centers and assistant professor of pediatric hematology at Baylor College of Medicine. She also is a member of the AAP Section on Hematology/Oncology.

In the following Q&A, Dr. Powers summarizes what she plans to discuss during the session and why pediatricians should attend.

Q: What is your background as it relates to iron deficiency and anemia?

A: I am a pediatric hematologist with a clinical and research focus on general hematology conditions, particularly iron deficiency anemia. During my fellowship training, I benefited from the mentorship of Dr. George Buchanan, and he encouraged me to focus on iron deficiency anemia given the number of children and teen girls affected.

Q: What are the key things you will be covering during the session?

A: This session will provide a broad overview from prevention to treatment of iron deficiency anemia. I'll touch briefly upon prevention of iron deficiency and screening considerations for identifying patients with risk factors for iron deficiency, highlight how to appropriately diagnose it using a variety of different clinical and laboratory considerations as well as provide updated treatment recommendations for patients confirmed to have iron deficiency, with or without anemia.

Q: How common is iron deficiency and anemia in pediatric patients?

A: Iron deficiency affects an estimated 2% to 3% of young children and between 9% and 16% of adolescent girls. School-age children and adolescent boys have less risk factors for the development of iron deficiency and therefore are less affected. A portion of those patients with iron deficiency progress to the most severe phase of iron deficiency, at which point red cell production becomes limited, resulting in iron deficiency anemia.

Q: What populations are at risk?

A: Young children who have a low-iron diet, most commonly related to excessive cow milk intake, are at risk for developing iron deficiency. Any child or adolescent who loses too much blood, which can include menstrual blood loss, gastrointestinal blood loss or other forms of blood loss, are also at risk for iron deficiency. It's also important to remember the association between pica, the craving for nonfood items such as dirt, paper or ice, and iron deficiency, as this can be the presenting symptom in many patients.

Q: Why is this an important topic for pediatricians to learn more about?

A: Iron deficiency anemia is the most common hematologic condition, affecting children across the pediatric lifespan. Yet, with a clear understanding of iron deficiency risk factors, appropriate therapy may be initiated, and the majority of children can be successfully treated resulting in improved quality of life.

Q: What is the take-home message of the session?

A: Iron deficiency probably affects more of your patients than you realize. Incorporating risk factor screening within your practice based on a patient's age and sex to identify those children at highest risk is a simple way to identify iron-deficient patients who may benefit from laboratory screening and low-dose, once-daily iron supplementation.

Q: Is there anything else you would like to add?

A: Iron deficiency often is overlooked because symptoms are fairly nonspecific and may develop gradually over time (fatigue, poor concentration, irritability, decreased endurance). However, when recognized and appropriately treated, many patients experience improved quality of life that is better appreciated after the fact. Further, early recognition prevents progression to more severe iron deficiency anemia, which can result in hospital admission and need for transfusion support.

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