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Anaemia in hospitalised infants: iron deficiency?
  1. T K Walter1,
  2. M Olivares1
  1. 1University of Chile, Santiago 13811, Chile; twalter@inta.cl
  1. C R Wall2,
  2. C C Grant2
  1. 2Department of Paediatrics, University of Auckland, Private Bag 92019, Auckland, New Zealand; cc.grant@auckland.ac.nz

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    Wall et al treated infants with alleged iron deficiency anaemia with several iron vehicles.1 However, anaemia in hospitalised ill infants is mostly not due to iron deficiency, but to anaemia of infection, present even with mild infections. That is why they find a paradoxical decrease of serum ferritin, that rises with infection, and falls after convalescence. Anaemia and all other measures of iron infection normalise without therapy.2 Thus, these results cannot be attributed to treatment. C reactive protein measurements are not completely reliable.

    References

    1. ↵
      Wall CR, Grant CC, Taua N, et al. Milk versus medicine for the treatment of iron deficiency anaemia in hospitalised infants. Arch Dis Child2005;90:1033–8.
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    2. ↵
      Olivares M, Walter T, Osorio M, et al. Anemia of a mild viral infection: the measles vaccine as a model. Pediatrics1989;84:851–5.
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    Authors’ reply

    Walter and Olivares question whether the anaemia present in the enrolled children was due to iron deficiency or due to the acute infection that precipitated their admission to hospital. They state that anaemia and all other measures of iron normalise without therapy. However their reference to both their earlier work and other published literature …

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