Comparative Improvement of RBC Indices and Hemoglobin After Oral Versus Iron Therapy in Patients of Iron Deficiency Anemia
Keywords:
Iron Deficiency Anemia, IVIS, OI, Serum ferritin, Hemoglobin
Abstract
Background: Iron Deficiency Anemia (IDA) is the single most prevalent nutritional deficiency worldwide. Oral iron therapy is the standard of care, however in some cases parenteral iron therapy is required. This study was undertaken to evaluate the comparative improvement of RBC indices and hemoglobin after treatment with IV Iron sucrose complex and oral iron in iron deficient patients. Methods: A retrospective study was conducted at Super Speciality Hospital in North India on 50 patients in Department of Pathology and Clinical Hematology who were diagnosed with IDA/state based on complete blood counts (CBC), iron studies and ferritin levels. Patients on chronic proton pump inhibitor therapy or celiac disease were treated with IV iron sucrose complex (IVIS) 100 mg for 10 days and remaining were given oral iron (OI), i.e. Ferrous sulfate 100 mg 2-3 times a day. All patients were given folic acid 5 mg daily in addition to iron therapy. Various hematological parameters were compared at day 12-15 days of therapy. Statistical analysis was done by student t test. Values were considered statistically significant when p<0.05. Result: - A total of 50 patients were included, out of which 10 received IVIS and 40 were treated with oral iron therapy. Patient belonged to age group 15-45 years. Although hemoglobin increased in both groups; rise in reticulocyte count, MCV, MCH, MCHC and increase in hemoglobin were higher in IVIS than in OI group at day 12-15 of therapy (25.7% vs 10.8%). IVIS has no major side effects. Compliance was not very good with OI group; 20% patients showed GI side effects and 5 patients left therapy because of the same.References
1. Alvarez-Uria G, Naik PK, Midde M, Yalla PS , Pakam R. Prevalence and Severity of Anemia Stratified by Age and Gender in Rural India. Anemia. 2014; Article ID 176182, 5 pages
2. World Health Organization. Reduction of maternal mortality. A joint WHO/UNFPA/UNICEF/World bank statement. Geneva: WHO; 1999.
3. Breymann C, Gliga F, Bejenariu C, Strizhova N. Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia. International Journal of Gynaecology & Obstetrics. 2008; 101:67-73.
4. Schrier SL. Treatment of anemia due to iron deficiency.Uptodate.com.2010; 3/19.
5. Breymann C. Treatment of iron deficiency anemia in pregnancy and postpartum with special focus on intravenous iron sucrose complex. Journal of the Medical Association of Thailand. 2005;88: S108-9.
6. Tan AE, and Siti SA. Intravenous iron-sucrose complex for treatment of Iron Deficiency Anemia in Pregnancy - experience in an Obstetric Day Care Clinic in a Tertiary Hospital. Medicine & Health, 2008; 3 (2): 288-293.
7. Bayoumeu F, Subiran-Buisset C, Baka NE, Legagneur H, Monnier-Barbarino P, Laxenaire MC. Iron therapy in iron deficiency anemia in pregnancy: Intravenous route versus oral route. Am J Obstet Gynecol. 2002; 186:518–22.
8. Silverstein SB, Rodgers GM. Parenteral iron therapy options. Am J Hematol. 2004; 76:74
9. Perewusnyk G, Huch R, Huch A, Breymann C. Parenteral iron therapy in obstetrics: 8 years’ experience with iron-sucrose complex. Br J Nutr. 2002; 88:3-10.
10. Abdullah et al. Intravenous iron sucrose vs oral iron therapy in treatment of pregnancy with moderate anemia:A prospective sudy in a tertiary care centre. International Journal of Basic and Applied Medical Sciences.2014; Vol.4(2):78-83
11. Kumar A, Jain S, Singh NP, Singh T. Oral versus high dose parenteral iron supplementation in pregnancy. Int J Gynaecol Obstet. 2005; 89:7–13.
12. Syal N, Nair NS, Rai L. Iron Sucrose Versus Oral Iron Therapy in Pregnancy Anemia.Indian J Community Medicine.2012; Oct-Dec 37(4):214-218
13. Al-Momen AK, Al-Meshari A, Al-Nuaim L, Saddique A, Abotalib Z, Khashogji T et al. Intravenous iron sucrose complex in the treatment of iron deficiency anemia during pregnancy. Eur J Obstet Gynecol Reprod Biol. 1996; 69:121–4.
2. World Health Organization. Reduction of maternal mortality. A joint WHO/UNFPA/UNICEF/World bank statement. Geneva: WHO; 1999.
3. Breymann C, Gliga F, Bejenariu C, Strizhova N. Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia. International Journal of Gynaecology & Obstetrics. 2008; 101:67-73.
4. Schrier SL. Treatment of anemia due to iron deficiency.Uptodate.com.2010; 3/19.
5. Breymann C. Treatment of iron deficiency anemia in pregnancy and postpartum with special focus on intravenous iron sucrose complex. Journal of the Medical Association of Thailand. 2005;88: S108-9.
6. Tan AE, and Siti SA. Intravenous iron-sucrose complex for treatment of Iron Deficiency Anemia in Pregnancy - experience in an Obstetric Day Care Clinic in a Tertiary Hospital. Medicine & Health, 2008; 3 (2): 288-293.
7. Bayoumeu F, Subiran-Buisset C, Baka NE, Legagneur H, Monnier-Barbarino P, Laxenaire MC. Iron therapy in iron deficiency anemia in pregnancy: Intravenous route versus oral route. Am J Obstet Gynecol. 2002; 186:518–22.
8. Silverstein SB, Rodgers GM. Parenteral iron therapy options. Am J Hematol. 2004; 76:74
9. Perewusnyk G, Huch R, Huch A, Breymann C. Parenteral iron therapy in obstetrics: 8 years’ experience with iron-sucrose complex. Br J Nutr. 2002; 88:3-10.
10. Abdullah et al. Intravenous iron sucrose vs oral iron therapy in treatment of pregnancy with moderate anemia:A prospective sudy in a tertiary care centre. International Journal of Basic and Applied Medical Sciences.2014; Vol.4(2):78-83
11. Kumar A, Jain S, Singh NP, Singh T. Oral versus high dose parenteral iron supplementation in pregnancy. Int J Gynaecol Obstet. 2005; 89:7–13.
12. Syal N, Nair NS, Rai L. Iron Sucrose Versus Oral Iron Therapy in Pregnancy Anemia.Indian J Community Medicine.2012; Oct-Dec 37(4):214-218
13. Al-Momen AK, Al-Meshari A, Al-Nuaim L, Saddique A, Abotalib Z, Khashogji T et al. Intravenous iron sucrose complex in the treatment of iron deficiency anemia during pregnancy. Eur J Obstet Gynecol Reprod Biol. 1996; 69:121–4.
Published
2018-09-26
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