**10. Evolution and prognosis**

After iron treatment, erythropoiesis with reticulocytosis efficiency occurs after 1–2weeks of- treatment, followed by an increase in hemoglobin levels. This increase (the so-called reticulocyte crisis) is not as expressed as in vitamin B12 or folic acid anemia treatment in megaloblastic- anemia. With treatment, anemia is corrected in about 1–2months, but for replenishing the iron- reserves, it is necessary to continue for about 4–6months of treatment.-

Prognosis of patients with IDA depends mainly on the underlying condition that caused iron deficiency and on the cardiovascular status of patients.-

Failure to respond to treatment with iron may occur in several circumstances, the more frequent observed being:


Celiac disease and *Helicobacter pylori* infection may reduce the absorption of iron, thus being a frequent cause of failure to oral iron treatment.

An important part of fighting iron-deficiency anemia is treating its underlying cause.-

Red blood cell transfusion is not generally required in iron-deficiency anemia, but in severe cases such as symptomatic patients associating cardiac pathology, transfusion is required in order to ameliorate symptoms until iron deficits are corrected.-

### **11. Conclusion**

Multiple factors can contribute to iron imbalance in the human organism. Reduced absorption,- increased losses, and/or increased requirements are the main mechanisms resulting in iron deficiency. Often such factors can coexist requiring a complex management of the consequent anemia. Iron therapy should be individualized by patient's characteristics. Treatment of underlying conditions is an important step toward reducing iron-deficiency-anemia-associated morbidity.-

#### **Conflict of interest-**

All authors have read and approved this version of the book chapter, and due care has been taken to ensure the integrity of the work. No part of this work has been published or submitted elsewhere. No financial conflict of interest exists in the submission of this manuscript.-

### **Author details**

Claudia Burz1,2\*, Andrei Cismaru1,3, Vlad Pop<sup>3</sup> and Anca Bojan<sup>4</sup>

\*Address all correspondence to: cburz@yahoo.fr

1 "Prof. Dr. Ion Chiricuţă" Oncology Institute, Cluj-Napoca, Cluj, Romania

2 "Iuliu Hatieganu" University of Medicine and Pharmacy, Department of Immunology and Allergology, Cluj-Napoca, Cluj, Romania

3 "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania-

4 "Iuliu Hatieganu" University of Medicine and Pharmacy, Department of Hematology, Cluj-Napoca, Cluj, Romania

### **References**


**Chapter 2**

**Provisional chapter**

**Iron Deficiency and Iron Deficiency Anemia in Children**

Iron deficiency anemia is considered the most common and widespread nutritional form of anemia in childhood. Red cells are hypochromic and microcytic with low mean corpuscular volume (MCV), low mean corpuscular hemoglobin (MCH) and low reticulocyte hemoglobin content (CHr). Red blood cell distribution width (RDW) is increased. Serum iron is reduced, transferrin is increased and serum ferritin is decreased. Prematurity, decreased dietary source, malabsorption and blood loss represent the most common causes of iron deficiency. Recommended oral dose of elemental iron is 2–6 mg/kg/day; when normal hemoglobin values are reached, treatment must be generally continued for 3 months in order to replenish iron stores. Rarely intravenous therapy is required. The pediatricians and other health care providers should strive to prevent and eliminate iron

**Keywords:** iron deficiency, anemia, children, hypochromic microcytic anemia,

In children, iron represents an essential nutrient for growth and proper function of many organs and systems, mainly erythropoiesis. It must be obtained from the diet and absorbed in the upper gastrointestinal tract. When iron requirements are not met, as when the balance of iron intake, iron stores and the body's loss are insufficient to fully support the production of erythrocytes, it is referred to as iron deficiency (ID). In 30% of cases, the ID, if left untreated, evolves in iron deficiency anemia (IDA) which represents the most frequent form of anemia

**Iron Deficiency and Iron Deficiency Anemia in Children**

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.79790

Roberto Miniero, Valentina Talarico, Maria Concetta Galati, Laura Giancotti, Paola Saracco and Giuseppe Raiola

Roberto Miniero, Valentina Talarico, Maria Concetta Galati, Laura Giancotti, Paola Saracco and Giuseppe Raiola

http://dx.doi.org/10.5772/intechopen.79790

**Abstract**

prevention

**1. Introduction**

in childhood.

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

deficiency and iron-deficiency anemia.
