Iron overload in children receiving prolonged parenteral nutrition

J Pediatr. 1993 Aug;123(2):238-41. doi: 10.1016/s0022-3476(05)81694-4.

Abstract

This study was carried out to evaluate the iron status of 30 children aged 1 to 18 years who had been receiving total parenteral nutrition (TPN) for an average of 43 months with iron intakes of 100 micrograms/kg per day. Iron status was assessed by assaying the serum iron and ferritin levels and the transferrin saturation coefficient as a function of iron intake. Liver biopsy specimens were taken from 13 children. Twelve children had serum ferritin levels greater than 300 ng/ml, and 8 had levels greater than 800 ng/ml. The serum ferritin level and the transferrin saturation coefficient were positively correlated (r = 0.81; p < 0.01). The serum ferritin level was positively correlated with TPN duration and with the total iron intake (r = 0.68; p < 0.01). Of the 13 liver biopsy specimens, six showed signs of iron deposition. We conclude that there is a risk of iron overload in children receiving 100 micrograms iron per kilogram of body weight per day by TPN, indicating that intake should be reduced.

MeSH terms

  • Adolescent
  • Alanine Transaminase / drug effects*
  • Alanine Transaminase / metabolism
  • Biopsy
  • Child
  • Child, Preschool
  • Ferritins / blood
  • Ferritins / drug effects*
  • Humans
  • Infant
  • Iron / metabolism
  • Iron / pharmacology*
  • Liver / drug effects*
  • Liver / metabolism
  • Liver / pathology
  • Parenteral Nutrition, Total*
  • Time Factors
  • Transferrin / drug effects*
  • Transferrin / metabolism

Substances

  • Transferrin
  • Ferritins
  • Iron
  • Alanine Transaminase