Treatment of iron deficiency anemia in developing countries: Should zinc be added?
International Pediatrics, cilt.23, sa.1, ss.11-16, 2008 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 23 Sayı: 1
- Basım Tarihi: 2008
- Dergi Adı: International Pediatrics
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.11-16
- Anahtar Kelimeler: Iron deficiency anemia, Zinc, Zn-protoporphyrin
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
This study was designed to investigate the frequency of zinc deficiency in infants and young children with iron deficiency anemia and their response to treatment with iron only or with a combination of iron and zinc. Sixty infants and children (18 girls, 42 boys) aged between 6 months and 4 years (mean age 18.13 ± 8.31 months) who presented to the Bakirkoy Maternity and Childhood Diseases Training Hospital were included in the study. Iron deficiency anemia was diagnosed in all cases. The patients were divided into 3 groups according to their serum zinc levels and the type of treatment to be administered. Group A (n=22) consisted of patients with normal serum zinc levels. Both group B (n=19) and group C (n=19) had low serum zinc level. For two months, groups A and B were given only iron and group C was given iron + zinc treatments. Zinc was administered as zinc sulphate, in a single dose of 1 mg/kg/day of zinc sulphate. Iron was given in a dose of 6 mg/kg/day of ferro-glycine-sulphate given in two doses. Zinc and iron were administered at different times of the day. Frequency of zinc deficiency in iron deficient patients and the response of hematological parameters to 2 months of treatment in these three groups were evaluated. In this group of infants and young children with iron deficiency anemia, the frequency of zinc deficiency was found to be 63.3 %. Following two months of treatment, there was no significant difference among the groups with respect to Hb, Hct, MCV, TIBC and Fe levels. However, a significant difference among the pretreatment and posttreatment RDW levels was noted in group B patients compared to those in group C. RDW levels significantly decreased in patients given zinc in addition to iron compared to patients treated with iron only. We attribute this result to the fact that in iron deficiency states zinc, instead of iron, is added to the structure of protoporphyrin, increasing the production of Zn-protoporphyrin and as a result serum zinc levels decrease. Since the frequency of coexistence of both iron and zinc deficiency is high in developing countries, zinc can be added to the treatment of iron deficient patients, especially to those who do not respond to iron treatment.