Iron Studies in Pediatrics
Iron Studies in Pediatrics
Iron studies comprise a panel of tests essential for evaluating iron status, diagnosing iron deficiency, and monitoring iron overload conditions in pediatric populations.
Key Points:
- Essential for growth and development assessment
- Critical in cognitive development monitoring
- Vital for hematopoiesis evaluation
- Age-specific reference ranges crucial
- Sequential testing often necessary
Core Iron Studies Parameters
- Serum Iron:
- Measures circulating iron
- Diurnal variation significant
- Morning collection preferred
- Age-specific ranges apply
- Ferritin:
- Storage iron marker
- Acute phase reactant
- Most sensitive early indicator
- Varies with inflammation
- Transferrin/TIBC:
- Iron transport capacity
- Inverse relationship with stores
- Affected by nutrition status
- Pregnancy affects levels
- Transferrin Saturation:
- Serum iron/TIBC × 100
- Functional iron availability
- Morning testing preferred
- Varies with inflammation
Additional Parameters
- Soluble Transferrin Receptor:
- Not affected by inflammation
- Reflects tissue iron demand
- Useful in chronic disease
- More expensive test
- Reticulocyte Hemoglobin:
- Early functional iron deficiency
- Real-time iron availability
- Useful in monitoring therapy
Primary Indications
- Screening:
- High-risk infants and toddlers
- Adolescent females
- Dietary restrictions
- Chronic diseases
- Diagnostic Evaluation:
- Unexplained anemia
- Growth failure
- Developmental delays
- Chronic fatigue
- Monitoring:
- Iron supplementation
- Chronic blood loss
- Hereditary conditions
- Therapeutic response
Special Populations
- Premature Infants:
- Enhanced monitoring needed
- Earlier screening initiation
- Higher supplementation needs
- Chronic Conditions:
- Inflammatory bowel disease
- Celiac disease
- Chronic kidney disease
- Thalassemia
Pattern Recognition
- Iron Deficiency:
- ↓ Ferritin
- ↓ Serum iron
- ↑ TIBC
- ↓ Transferrin saturation
- Iron Overload:
- ↑ Ferritin
- ↑ Serum iron
- Normal/↓ TIBC
- ↑ Transferrin saturation
- Anemia of Chronic Disease:
- Normal/↑ Ferritin
- ↓ Serum iron
- ↓ TIBC
- ↓ Transferrin saturation
Confounding Factors
- Inflammatory States:
- Acute phase response
- Chronic inflammation
- Recent infections
- Technical Factors:
- Timing of collection
- Recent iron intake
- Hemolysis
Age-Related Reference Ranges
- Neonates (0-1 month):
- Ferritin: 25-200 ng/mL
- Transferrin saturation: 35-85%
- Serum iron: 100-250 µg/dL
- Infants (1-12 months):
- Ferritin: 15-80 ng/mL
- Transferrin saturation: 20-50%
- Serum iron: 40-100 µg/dL
- Children (1-12 years):
- Ferritin: 12-140 ng/mL
- Transferrin saturation: 15-50%
- Serum iron: 50-120 µg/dL
- Adolescents (>12 years):
- Ferritin: 15-150 ng/mL
- Transferrin saturation: 15-50%
- Serum iron: 60-160 µg/dL
Treatment Strategies
- Iron Supplementation:
- Oral iron formulations
- Dosing schedules
- Duration of therapy
- Side effect management
- Monitoring Protocol:
- Response assessment timing
- Follow-up intervals
- Treatment adjustment criteria
- Duration of monitoring
- Prevention Strategies:
- Dietary counseling
- Risk factor modification
- Supplementation guidelines
- Screening protocols
Special Considerations
- Dietary Factors:
- Iron-rich foods
- Absorption enhancers
- Absorption inhibitors
- Meal timing
- Compliance Strategies:
- Side effect minimization
- Administration timing
- Product selection
- Educational support
