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Randomized Controlled Trial
. 2022 Sep;92(3):762-766.
doi: 10.1038/s41390-022-02136-2. Epub 2022 Jun 9.

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

Doaa El Amrousy  1 , Dalia El-Afify  2 , Abdallah Elsawy  3 , Mai Elsheikh  4 , Amr Donia  4 , Mohammed Nassar  4
Affiliations
Randomized Controlled Trial

Lactoferrin for iron-deficiency anemia in children with inflammatory bowel disease: a clinical trial

Doaa El Amrousy et al. Pediatr Res. 2022 Sep.

Abstract

Background: Iron-deficiency anemia (IDA) is common in children with inflammatory bowel disease (IBD); however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects. We compared the effect of lactoferrin versus oral ferrous sulfate for the treatment of IDA in children with IBD.

Methods: Ninety-two IBD children with IDA were included but only 80 children completed the study and they were randomized into two groups: ferrous sulfate group (n = 40) who received ferrous sulfate 6 mg/kg/day for 3 months and lactoferrin group (n = 40) who received lactoferrin 100 mg/day for 3 months. Complete blood count, serum iron, total iron-binding capacity (TIBC), transferrin saturation (TS), serum ferritin, interleukin-6 (IL-6), and hepcidin 25 were measured before and after the treatment.

Results: Hemoglobin (Hb), mean corpuscular volume, serum iron, TS, and serum ferritin significantly increased, while TIBC decreased significantly after the administration of either ferrous sulfate or lactoferrin compared to their baseline data. In addition, lactoferrin significantly increased Hb, serum iron, TS, and serum ferritin compared to ferrous sulfate. Moreover, lactoferrin significantly decreased IL-6 and hepcidin levels.

Conclusion: Lactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA.

Clinical trial registration: The study was registered at www.pactr.org (PACTR202002763901803).

Impact: Iron-deficiency anemia (IDA) in children with inflammatory bowel disease (IBD) is treated with oral iron therapy; however, oral iron supplements are commonly associated with poor compliance due to gastrointestinal side effects. To the best of our knowledge, our study was the first in pediatrics that compared the effect of lactoferrin versus oral ferrous sulfate as an iron supplement for the treatment of IDA in children with IBD. We found that lactoferrin is a promising effective treatment with fewer side effects than oral elemental iron in children with IBD and IDA.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study showing details of enrollment, allocation, follow up, and analysis of the patients.
See this image and copyright information in PMC

References

    1. Carvalho FSG, de Medeiros IA, Antunes H. Prevalence of iron deficiency anemia and iron deficiency in a pediatric population with inflammatory bowel disease. Scand. J. Gastroenterol. 2017;52:1099–1103. doi: 10.1080/00365521.2017.1342137. - DOI - PubMed
    1. Lopes AI, et al. Portuguese consensus on diagnosis, treatment, and management of anemia in pediatric inflammatory bowel disease. GE Port. J. Gastroenterol. 2020;27:244–254. doi: 10.1159/000505071. - DOI - PMC - PubMed
    1. Aljomah G, et al. Anemia in pediatric inflammatory bowel disease. JPGN. 2018;67:351–355. - PubMed
    1. Mattiello V, et al. Diagnosis and management of iron deficiency in children with or without anemia: consensus recommendations of the SPOG Pediatric Hematology Working Group. Eur. J. Pediatr. 2020;179:527–545. doi: 10.1007/s00431-020-03597-5. - DOI - PubMed
    1. Kaitha S, Bashir M, Ali T. Iron deficiency anemia in inflammatory bowel disease. World J. Gastrointest. Pathophysiol. 2015;6:62–72. doi: 10.4291/wjgp.v6.i3.62. - DOI - PMC - PubMed

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