IRON DEFICIENCY. PART 2: CLINICAL MANIFESTATIONS, PREVENTION AND THERAPY

Key words: Iron deficiency, Anemia, Transferrin, Ferritin, Developmental disorders (and iron deficiency), Learning disabilities (and iron deficiency), Breath holding (and iron deficiency), Spells

Part II of the review on iron deficiency (ID) is devoted to clinical manifestations, prevention and treatment. Pallor and fatigue are increasingly rare as presenting signs and symptoms of ID in industrialized countries. More subtle conditions such as developmental disorders and learning disabilities may be caused by ID but many other factors may be involved in their etiology. ID may protect the child form infection, and, conversely, iron overload can enhance the virulence of pathogens such as Yersinia enterocolitica. Serum iron may be low during infections and chronic diseases even in absence of true ID. Breath holding spells and febrile convulsions have been recently related to ID. Iron fortification of cereals and follow-up formula are widely used but thay does not appear justified in Italy due to the low prevalence of ID. Only preterm infants should be supplemented with iron, with dosage depending on their birth weight. Oral administration of bivalent iron (2-3 mg/kg/day) represent the first choice treatment of ID.