Abstract
A group of 67 children with cyanotic congenital heart disease (CCHD) were studied, and 35 were given iron treatment according to a regimen that gives iron to patients with a hematocrit (Hct) below 60%. The patients were categorized as iron-deficient and iron-sufficient according to their transferrin saturation and ferritin values. The pretreatment hemoglobin (Hb) and Hct values of the groups were similar. The mean Hct was nearly three times as much as the mean Hb in the iron-sufficient group and more than three times as much as the Hb in the iron-deficient group. Excessive erythrocytosis in the iron-deficient group was impressive. Mean corpuscular volume (MCV) values were below 72.7 fl in all of the iron-deficient patients. After treatment the Hb, Hct, transferrin saturation, and ferritin increased significantly in both groups, with the increments greater in the iron-deficient group. Increments in the erythrocyte (RBC) count were significant in the iron-sufficient group but insignificant in the iron-deficient one. Increments of MCV in the iron-deficient group were significant but insignificant in the iron-sufficient group. Our study demonstrated that prediction of Hb, RBC count, and MCV, measurements of which are easy and inexpensive and require little blood, can suffice for the diagnosis of iron deficiency in patients with CCHD without altering systemic perfusion.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Amital Y, Blieden L, Shemtov A, Neufeld H (1984) Cerebrovascular accidents in infants and children with congenital cyanotic heart disease.Isr J Med Sci 220:1143–1145
Anderson RH, McCartney FJ, Shinebourne EA, Tunan M (1987)Paediatric Cardiology, Vol 2. Churchill Livingstone, London, pp 774–775
Beekman HR, Tuuri DT (1985) Acute hemodynamic effects of increasing hemoglobin concentration in children with a right to left ventricular shunt and relative anemia.J Am Coll Cardiol 5:357–362
Buchowski MS, Mahoney AW, Kalpalathika PV (1989) Nonheme iron absorption, apparent iron absorption and hemoglobin regeneration efficiency in anemic and normal rats fed with dietary heme and nonheme iron at various levels.Nutr Rev 9:773–783
Cottrill CM, Kaplan S (1973) Cerebral vascular accidents in cyanotic congenital heart disease.Am J Dis Child 125:484–487
Drossos C, Thanatopoulos B, Papadimitriou T, et al (1981) Incidence of anaemia in congenital heart diseases.Pediatr Med Chir 3:309–312
Finch CA (1982) Erythropoiesis, erythropoietin, and iron.Blood 60:1241–1246
Gidding SS, Bessel M, Liao Y (1990) Determinants of hemoglobin concentration in cyanotic heart disease.Pediatr Cardiol 11:121–125
Huebers HA, Finch CA (1987) The physiology of transferrin and transferrin receptors.Physiol Rev 67:520–582
Hutton RD (1979) The effect of iron deficiency on whole blood viscosity in polycythaemic patients.Br J Haematol 43:191–199
Linderkamp O, Klose HJ, Betke K, et al (1979) Increased blood viscosity in patients with congenital heart disease and iron deficiency.J Pediatr 95:567–569
Neches WH, Park SC, Ettedgui JA (1990) Tetralogy of Fallot and tetralogy of Fallot with pulmonary atresia. In: Garson A, Bricker JT, McNamara DG (eds)The Science and Practice of Pediatric Cardiology, Vol 2. Lea & Febiger, London, pp 1073–1100
Oski FA (1981) The erythrocyte and its disorders. In: Nathan DG, Oski FA (eds)Hematology of Infancy and Childhood, 2nd edn. Saunders, Philadelphia, pp 20–21
Rosenthal A, Button L, Nathan D, Miettinen OS, Nadas AS (1971) Blood volume changes in cyanotic congenital heart disease.Am J Cardiol 27:162–167
Rudolph AM, Nadas AS, Borges WH (1953) Hematologic adjustments to cyanotic congenital heart disease.Pediatrics 11:454–463
Sondel PM, Tripp ME, Ganick DJ, Levy JM, Shahidi NT (1981) Phlebotomy with iron therapy to correct the microcytic polycythemia of chronic hypoxia.Pediatrics 67:667–670
Stockman JA (1992) Anemias resulting from inadequate production of red blood cells. In: Behrman RE (eds)Nelson Textbook of Pediatrics, 14th edn. Saunders, Philadelphia, pp 1232–1241
Sümbüloĝlu K, Sümbüloĝlu V (1990) Biyoistatistik, 3rd ed. Hatipoλu Yaymlari, Ankara, pp 48–174
Theodore J, Robin ED, Burke CM, et al (1985) Impact of profound reductions of PaO2 and O2 transport and utilization in congenital heart disease.Chest 87:293–302
Van De Pette JEW, Guthrie DL, Pearson TC (1986) Whole blood viscosity in polycythemia: the effect of iron deficiency at a range of haemoglobin and packed cell volumes.Br J Haematol 63:369–375
Verel D (1961) Blood volume changes in cyanotic congenital heart disease and polycythemia rubra vera.Circulation 23:749–753
West DW, Scheel JN, Stover R, Kan J, DeAngelis C (1990) Iron deficiency in children with cyanotic congenital heart disease.J Pediatr 8:266–268
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Olcay, L., Özer, S., Gürgey, A. et al. Parameters of iron deficiency in children with cyanotic congenital heart disease. Pediatr Cardiol 17, 150–154 (1996). https://doi.org/10.1007/BF02505204
Issue Date:
DOI: https://doi.org/10.1007/BF02505204