Pienentynyt ferritiinipitoisuus lapsella : niukat rautavarastot ilman anemiaa

Abstract

<div lang="fi" class="abs"><p class="abs_header">Tiivistelmä</p><p>Laadukas tutkimusnäyttö puuttuu rautalisän hyödystä lapsille, joilla ei ole raudanpuuteanemiaa.</p><p>Lapsia ei tulisi seuloa raudanpuutteen varalta, eikä diagnoosia tehdä yksin seerumin ferritiinipitoisuuden perusteella.</p><p>Jos lapsella on raudanpuutteeseen sopivia oireita ja ferritiinipitoisuus on pienempi kuin 15 µg/l, suun kautta otettavan rautalisän voi aloittaa, mikäli lapsella ei ole raudan kertymiselle altistavaa sairautta. Hoidon vastetta tulee seurata.</p><p>Lapselle suoneen annosteltavan rautalääkityksen tarpeen arvioiminen ja toteutus kuuluvat erikoissairaanhoitoon.</p></div>

<div lang="en" class="abs"><p class="abs_header">Abstract</p><p>Iron deficiency without anaemia in children has been a topic of lively public discussion. It has been suggested that diminished iron stores evident only as low blood ferritin concentrations cause a plethora of unspecific symptoms including fatigue, difficulties with learning, as well as attention deficit problems. While evidence for iron deficiency anaemia causing health problems is solid, the causality between iron deficiency without anaemia and various symptoms has not been shown. Furthermore, assessing iron stores by measuring proxy markers from the peripheral blood is often ambiguous. It is also worth remembering that even oral iron substitution has side-effects, especially when treating children with relatively mild symptoms. Accordingly, we suggest a conservative approach when evaluating children with low ferritin levels without changes in the blood cell count that are characteristic for iron deficiency. We suggest that clinicians consider oral iron substitution for children with ferritin < 15 µg/l if the child has related symptoms. If iron medication is prescribed, its effect on symptoms and ferritin should be evaluated. Screening for iron deficiency by measuring ferritin is not justifiable among healthy Finnish children. Intravenous iron infusions should be given only for carefully selected cases in specialist health care.</p></div>