INAPPROPRIATE IRON INTAKE IN CHILDREN ON LONG-TERM PARENTERAL-NUTRITION - OUTCOME AFTER IRON WITHDRAWAL

Inappropriate parenteral iron intake in children on long-term parenter al nutrition can be responsible for iron overload. This study was carr ied out to monitor iron status changes when iron parenteral intake was stopped in case of iron overload. Seven children with serum ferritin concentrations above 800 ng/ml (6 with documented liver iron overload) were prospectively studied after total discontinuation of parenteral iron intake and without chelation therapy. tron status was assessed, b y means of ferritin and iron plasma concentrations, 8-15 months (T-1) and 24-30 months (T-2) after withdrawal of parenteral iron. Ferritin a nd iron concentrations declined at T-1 or T-2 in all but two children. At T-2 ferritin and iron concentrations were significantly tower (P< 0.05) than before iron parenteral discontinuation with a yearly reduct ion of 22 +/- 15% and 15 +/- 16%, respectively, for ferritin concentra tion and iron concentration. This fall in serum ferritin concentration is comparable to thalassemic subjects after bone marrow transplantati on. The total withdrawal of parenteral iron intake improves iron statu s in chidren with iron overload. Neverthless, iron overload related pa renteral nutrition should be avoided by lowering iron intake incase of long-term total parenteral nutrition and by careful monitoring.