Journal of Pediatric Research and Neonatal Care

The Intravenous Iron Formulation Sodium Ferric Gluconate Complex for Pediatric Inpatients with Iron Deficiency Anemia

Bradley A Warady*, Eileen Finan

The Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA

Abstract

Background: Iron deficiency anemia (IDA) is a prevalent issue among pediatric inpatients. Sodium ferric gluconate complex (SFGC) is employed at our institution for the rapid restoration of iron levels in patients who are unable to take or tolerate oral iron.

Objective: This study aims to evaluate the effectiveness of SFGC and assess the incidence of adverse drug reactions (ADRs).

Methods: A retrospective analysis was conducted, reviewing SFGC infusions administered to hospitalized patients aged under 18 with IDA or following acute blood loss. The study spanned from January 1st, 2008, to April 20th, 2015.

Results: Sixty-five inpatients received a total of 1586 infusions in 738 courses, involving daily 1-3 mg/kg infusions, followed by laboratory tests within 2-4 days. The mean number of infusions per course was 2.06±1.08, the mean dose per course was 4.6±3.1 mg/kg, and the mean age was 8.43±6.64 years. Infusions were administered to 18.4% of infants and 24.4% of children aged 1-<7 years. The largest patient diagnoses group comprised gastrointestinal diseases (175 of 738, 23.7%), with 64.6% (113) of those cases being inflammatory bowel disease. Comparing pre to post infusion values, there were significant increases in iron saturation, ferritin, reticulocyte count, and hemoglobin across all diagnoses and age groups. Erythropoietin injections accompanied 85.8% of the courses. Those who received erythropoietin had higher reticulocyte counts and lower ferritin levels compared to those who did not receive it (59.16±70.75 vs. 8.32±75.11, p=.005 and 81.61±179.01 vs. 134.84±117.87, p=.027 respectively). Two patients experienced transient hypotension but completed the infusions.

Conclusion: SFGC infusions swiftly improved iron studies induced hematopoiesis across all age and diagnosis groups and demonstrated a favorable safety profile without significant ADRs. Further examination is warranted to determine the safety of SFGC in neonates.

Keywords:

Pediatric anemia, iron deficiency anemia, Ferric gluconate, erythropoietin, intravenous iron