Background Iron deficiency (ID) is common in patients with cystic fibrosis (CF). In adult CF patients ID is related to lung disease severity and thought to be caused by chronic inflammation. Increased iron levels in sputum are associated with P. aeruginosa infections.
Aim To establish the prevalence of ID and iron deficiency anemia (IDA) in children with CF and associations of ID with dietary iron intake, lung disease severity and Pseudomonas aeruginosa infection.
Methods Clinical charts of 54 children with CF aged 0 to 16 were reviewed. Follow-up varied from 1 to 14 years with 346 annual observations in total. Laboratory data (hemoglobin (Hb), serum ferritin (SF)) and results of pulmonary function tests, sputum cultures and 3-day food records were collected.
Results 46 children (85.2%) were iron deficient (SF<30µg/l) in at least one year and ID was present in 329 of 346 observations (95.1%). IDA (SF<30 µg/l and Hb >2SD below the mean of similarly aged children) was present in 8 observations (2.4%) in 6 patients (11.1%). Children with ID were younger (6.4 year versus 10.6 year, p=0.00) and had less pulmonary exacerbations (p=0.01). ID was not associated with FEV1, Pseudomonas aeruginosa infection or dietary iron intake.
Conclusion ID is common in young children with CF and associated with less pulmonary exacerbations. We suggest that ID in these children is caused by rapid growth and accelerated erythropoies instead of disease severity or insufficient dietary iron intake.