Abstract
The purpose of this study was to determine the value of combining laboratory tests of iron status in predicting a rise in hemoglobin (Hb) in infants undergoing a therapeutic trial of iron. Screening for anemia was performed on capillary blood of 1128 healthy one-year-old infants of air force personnel. The 25% who had Hb < 11.5 g/dl were asked to return for tests on venous blood before and again after 3 mo of therapy. Of the total of 188 infants completing therapy, 66 (35%) had a rise in Hb ≥ 1.0 g/dl and were designated responders. Each additional laboratory test on venous blood showed a marked degree of overlap in results on responders vs non-responders. We used MCV < 70 fl, erythrocyte protoporphyrin > 3 μg/g Hb, transferrin saturation < 10%, and plasma ferritin < 10 μg/1 as cutoff values. For each individual test, about half of those with abnormal values had a response. However, it was disturbing to find that for any given test, half to two-thirds of the responders had a normal value. Because of the difficulty in distinguishing responders from non-responders and the simplicity, low cost, and low prevalence of side effects, we favor the use of a therapeutic trial based on only a low Hb in similar high-risk populations. Further costly workup could then be reserved for the small number of infants who have unexplained anemia (Hb < 11.0 g/dl) after a therapeutic trial.
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Reeves, J., Drigqers, D., Lo, E. et al. 860 DIAGNOSIS OF IRON DEFICIENCY IN ANEMIC ONE-YEAR-OLD INFANTS: THE LIMITATIONS OF LABORATORY TESTS IN PREDICTING RESPONSE TO IRON TREATMENT. Pediatr Res 15 (Suppl 4), 586 (1981). https://doi.org/10.1203/00006450-198104001-00885
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DOI: https://doi.org/10.1203/00006450-198104001-00885