Evaluation of iron deficiency anemia during acute infection in children

Aims: The purpose of this study was to assess changes in infection and iron parameters during infection and at least 4-6 weeks after recovery in children diagnosed with infections, to investigate the impact of infection on iron metabolism and to determine the prevalence of iron deficiency anemia (IDA). Methods: In this study, 151 patients who presented with fever, were diagnosed with an infection as the source of the fever, had no prior anemia investigations or antianemic treatment, and had no history of recurrent infections or chronic diseases, between September 2005 and October 2005 were included. In addition to specific tests focused on the site of infection, complete blood count, serum iron, serum total iron-binding capacity (TIBC), ferritin, C-reactive protein (CRP), transferrin saturation, and peripheral smear levels were measured at the time of admission and 4-6 weeks after follow-up. Results: The mean age of the patients was 4.5 ± 3.2 years, and 57.6% (n = 87) of them were male. During the infection, 12% of the cases (n = 18) showed iron deficiency, and 53% (n = 80) were diagnosed with IDA. After infection, iron deficiency was identified in 5% of the cases (n = 7), while IDA was present in 37.1% of the cases (n = 50). A significant decrease in both iron deficiency (12% vs. 5%, p = 0.001) and IDA (53.0% vs. 37.1%, p = 0.001) ratios was observed after the infection. The group with IDA showed a larger decrease in leukocyte and CRP levels compared to the group without IDA, alongside a more marked increase in TIBC levels. Conclusion: The reduction in iron deficiency and IDA rates following infection suggests that infection may lead to substantial changes in iron metabolism. Monitoring iron parameters during the infection phase in pediatric patients may play a crucial role in distinguishing anemia of inflammation from IDA.