Complex Therapy of Iron Deficiency Anemia in Children
The article presents the results of effectiveness assessment of the therapy for iron deficiency anemia in children (n=62) at the age from 11 months to 18 years old. The average age is 8.6±2.9 years. The initial hemoglobin level ranged from 61 g/l to 111 g/l with a median of 84.4 (72.40...96.00) g/l. In the structure of the pathology, severe anemia was verified in 17.7% of patients (n=11), moderate one - in 45.2% (n=28), and mild anemia - in 37.1% (n=23). All children received oral ferrotherapy with Tothema, which contains gluconates of divalent trace elements: Fe (50 mg), Mn (1.33 mg), and Cu (0.7 mg). The daily therapeutic dose of elemental Fe was 5 mg/kg of the child's weight (maximum - 150 mg per day); at the supportive phase of therapy - 2-2.5 mg/kg (maximum - 50 mg per day). In hematological indices, on the 7th day of ferrotherapy, a significant positive dynamics was noted: a significant increase of the hemoglobin level (by 3.83 g/l), hematocrit (by 4.32%), and the number of reticulocytes (by 5.62%). The medians (Me) of these indices were respectively: 88.20 (79.50...94.20) g/l; 31.72 (27.01...38.10) % and 6.80 (2.00...8.00) %. In 4 weeks of ferrotherapy, normalization of hemoglobin level was observed in the majority of patients (83.9%): the median was 118 (115.50...128.50) g/l, and it significantly exceeded the initial values. At the same time, in the majority of patients, normalization of serum ferritin concentration was recorded: Ме=23.98 (18.23...39.15) mkg/l against 6.20 (5.10...8.70) mkg/l initially (p<0.05). At the 2nd month of follow-up, all patients noted a replenishment of the iron deposition: Me of serum ferritin - 43.96 (24.42...59.54) mkg/l. By the end of the second stage of ferrotherapy (saturation of the iron deposition), transferrin indices significantly decreased: the median was 2.86 (2.32...3.39) g/l, which was statistically significantly different from the initial values - 3.79 (3.62...4.26) g/l). The study revealed high tolerance to Tothema; no side effects were noted. The obtained results indicate a high therapeutic effectiveness and safety of the complex drug of ferrous gluconate Tothema in the treatment of iron deficiency anemia of various severity in children and adolescents.