Железодефицитные новости

[Dr.Vad]

дефицит железа и тики у детей с синдромом Туретта - похоже, что коррекция ЖД может снизить их интенсивность:

In 57 patients, M:F = 2:1, serum ferritin was 48.0 ± 33.28 ng/mL, tic severity score 2.3 ± 0.80, impact on life score 2.2 ± 0.93, and composite score 4.57 ± 1.6. Serum ferritin was not influenced by comorbid obsessive compulsive disorder (OCD), attention deficit hyperactive disorder (ADHD), or anxiety (P > 0.16); 38% with low serum ferritin (≤50 ng/mL) (n = 37) had severe tics (>5 composite score), compared with 25% in normal ferritin group (n = 20). Over 6-12 months, tic severity score improved in both iron treated groups, deficient (2.70 to 1.90) and sufficient (2.40 to 1.95), whereas tics worsened or remained the same when not treated with iron.
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Childs Nerv Syst. 2017 May 3.
Relationship of serum ferritin level and tic severity in children with Tourette syndrome.
Ghosh D, Burkman E.

[Dr.Vad]

Наводящие вопросы не всегда могут предсказать ЖД и ЖДА у подростков:

J Pediatr. 2017 May 9.
Risk-Based Questionnaires Fail to Detect Adolescent Iron Deficiency and Anemia.
[Ссылки доступны только зарегистрированным пользователям ]

[Dr.Vad]

Вот такое научное наблюдение, почему хелат железа с глицином быть может имеет преимущества перед неорганическими соединениями железа при ликвидации ЖДА:

Haematologica. 2017 May 11.
Extracellular glycine is necessary for optimal hemoglobinization of erythroid cells.
[Ссылки доступны только зарегистрированным пользователям ]

[Dr.Vad]

мигренозные боли, рецидив. боли в животе, спине и синдром беспокойных ног у детей ассоциируются с наличием дефицита железа:

Iron deficiency remained significantly associated with migraine (OR 2.38), persistent pain (OR 3.70) and restless legs syndrome (OR 5.10).
the common pain conditions, persistent pain, restless legs syndrome, iron deficiency, anxiety and depression, are likely to involve common etiological mechanisms
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Clin J Pain. 2017 Mar 7.
Common Pediatric Pain Disorders and their Clinical Associations.

[Dr.Vad]

Интересный опыт лечения аффективно-респираторных приступов препаратами железа из Индии: лечение помогало многим даже у тех, кого не было дефицита железа по ферритину:

Study population comprised of patients aged 6-36 months, attending a paediatric outpatient department with recurrent episodes (more than three in last 4 weeks) of breath holding spells. Children with loss of consciousness or convulsive movements associated with breath holding spells were considered as severe. After baseline investigations, all enrolled patients were given elemental iron at the dose of 3 mg/kg/day as a single daily dose. Four weekly follow-ups were done until 3 months after initiation of the intervention. At 12 weeks, investigations were repeated and outcome assessed for remission or decrease in severity of breath holding episodes.

A total of 100 children with breath holding spells received iron supplementation. Almost 73% of children showed complete response, with another 23% showing greater than 50% reduction in frequency. Frequency of spells at diagnosis and intolerance to oral iron were significantly associated with poor response to iron supplementation. Other factors such as age at onset, age at presentation, severity of spells, anaemia and serum iron parameters had no significant association with the response. Of the 27 children without iron deficiency (serum ferritin ≥ 30 µg/L), 77.7% responded completely to iron supplementation, similar to the iron-deficient group.
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J Paediatr Child Health. 2017 Jun 1.
Effect of iron supplementation in children with breath holding spells.

[Dr.Vad]

У женщин с ЖДА синдром дефицита внимания/гиперактивности встречается в 6 раз чаще (почти у каждой пятой):

83 newly diagnosed iron deficiency anemia patients and 70 healthy controls were included in this study. All participants were assessed using a sociodemographic form, Structured Clinical Interview I (SCID-I), Wender Utah Rating Scale (WURS); Moreover, participants having WURS scores 36 and above were also assessed using the Adult ADD/ADHD Evaluation Scale and interviewed according to DSM-5 criteria. In the study, 22.9% of patients with iron deficiency anemia and 12.9% of healthy controls were found to have WURS scores 36 and above. Fifteen patients (18.1%) in iron deficiency anemia group and two patients (2.9%) in control group had adult ADHD, when they were evaluated with Adult ADD/ADHD Evaluation Scale and interviewed according to DSM-5 criteria (p=0.007). The patients with iron deficiency anemia had significantly higher WURS scores compared to controls (p=0.002).
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Noro Psikiyatr Ars. 2017 Mar;54(1):72-77.
The Investigation of Symptoms and Diagnoses of Adult-Attention Deficit/ Hyperactivity Disorder in Women with Iron Deficiency Anemia.

[Dr.Vad]

Железа сульфат против мальтофера для лечения ЖДА у детей 1-3 летнего возраста:

Of 80 randomized infants and children (median age, 22 months; 55% male; 61% Hispanic white; 40 per group), 59 completed the trial (28 [70%] in ferrous sulfate group; 31 [78%] in iron polysaccharide complex group). From baseline to 12 weeks, mean hemoglobin increased from 7.9 to 11.9 g/dL (ferrous sulfate group) vs 7.7 to 11.1 g/dL (iron complex group), a greater difference of 1.0 g/dL (95% CI, 0.4 to 1.6 g/dL; P < .001) with ferrous sulfate (based on a linear mixed model). Proportion with a complete resolution of IDA was higher in the ferrous sulfate group (29% vs 6%; P = .04). Median serum ferritin level increased from 3.0 to 15.6 ng/mL (ferrous sulfate) vs 2.0 to 7.5 ng/mL (iron complex) over 12 weeks, a greater difference of 10.2 ng/mL (95% CI, 6.2 to 14.1 ng/mL; P < .001) with ferrous sulfate. Mean total iron-binding capacity decreased from 501 to 389 μg/dL (ferrous sulfate) vs 506 to 417 μg/dL (iron complex) (a greater difference of -50 μg/dL [95% CI, -86 to -14 μg/dL] with ferrous sulfate; P < .001). There were more reports of diarrhea in the iron complex group than in the ferrous sulfate group (58% vs 35%, respectively; P = .04).

JAMA. 2017 Jun 13;317(22):2297-2304.
Effect of Low-Dose Ferrous Sulfate vs Iron Polysaccharide Complex on Hemoglobin Concentration in Young Children With Nutritional Iron-Deficiency Anemia: A Randomized Clinical Trial.
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