High prevalence of iron deficiency in the pediatric population of Israel

Purpose. Iron deficiency (ID) may be responsible for impairment in the general "well being" and performance of everyday activities in children. It may be easily overlooked and become irreversible if not treated in time. The clinical importance of this issue on a national scale led us to investigate the prevalence of iron deficiency in the Israeli pediatric population. Patients. Iron status was evaluated in four groups of participants: 1. pediatric visitors to primary care clinics, 2. pre - elective surgery patients, 3. Well-infants clinic (18-24 months) and 4. healthy adolescent female students (15-17 years). Results. Of 1429 children in primary pediatric clinics 43% had high RDW (>15%). Elevated RDW (>15%) and reduced MCV (< -2SD for age) were demonstrated in 9.2%, 16.2%, 9.9% and 9% of 131 children age 1-2 years, 622 aged 3-7 years, 487 aged 8-11 years and 189 aged 12-16 years, respectively. Laboratory profile, performed on randomly chosen 35 children with high RDW, disclosed a significant negative correlation between soluble transferrin receptor level and hemoglobin, hematocrit, MCV, MCH and serum iron concentrations. No correlation was found between serum ferritin and iron, or soluble transferrin receptors. Increased RDW (>15%) and reduced MCV (<-2SD for age) were noticed in 11% of 35 children (aged 1 - 15 years) reffered for elective surgery. Anemia (hemoglobin level <110gr./L) was present in 30 of 239 (12.5%) healthy infants (18-24 months) in well infants clinics. Low MCV (<72fL) and high RDW (>15%) were recorded in 27% and 34% of the infants, respectively. Anemia (hemoglobin < 120gr/L) was evident in 3.6% of 222 female adolescent students. Decreased ferritin (<10mcg/L) and transferrin saturation (<16%) were found in 24% and 27% of them, respectively. Conclusions. There is a high prevalence of iron deficiency among the pediatric population in Israel. Pediatricians should focus on early diagnosis of iron deficiency and appropriate therapy should be instituted to avoid the deleterious effects of chronic iron deficiency in children.