Intravenous delivery of iron dextran:

23 years-experience in a single institution 

Autores: Alvarado Ibarra Martha Leticia, López Hernández Manuel Antonio, Álvarez Vera José Luis, Ortiz Zepeda Santa M, Palomo Farías Fernando

Resumen

Objective: To analyze the clinicopathologic characteristics of patients with iron deficiency anemia treated with intravenous iron in a Specialty Hospital. Material and method: A retrospective study was performed including patients older than 15 years with iron deficiency anemia who were treated with intravenous iron dextran from 1987 to 2010. Clinical/electronic records of patients registered in the hematology service of the 20 de Noviembre Hospital, Mexico City, between July and August 2010 were included, obtaining the data requested in the data collection sheet to evaluate the following variables: sex, age, date of infusion, lab results with a period of no longer than 1 month ago iron administration, involving serum levels of hemoglobin (<12 g/dL in women and <14 g/dL in men to define the presence of anemia), hematocrit, mean corpuscular volume and hemoglobin percentage of corrected reticulocytes red cell distribution width (RDW), iron profile (serum iron, transferrrin, transferrin saturation index, total capacity and latent iron binding), ferritin and Perls staining. Results: 761 infusions were done, 110 men and 651 women, average age 52 years, mean Hb and iron deficiency 8.7g/dL of 1,285mg/dL were performed. The main causes were diseases associated with lower gastrointestinal bleeding (48%), including those secondary to treatment (not chronic peptic rheumatological disease, rheumatologic disorders, arthropathy and hepatic cirrhosis) and abnormal uterine bleeding (27%). In 49% of cases there were at least 2 cases and 79% were administered multiple drugs, of these, 45% were potentially harmful to the gastrointestinal mucosa (NSAIDs, antiplatelet agents, oral anticoagulants andsteroids) and 27% had polypharmacy (> 5 drugs). There were 111 patients in recurrent anemia, with an average of 3 infusions per patient in this group and an interval of 55 weeks. The number of reported serious adverse events was 0.26% and no cases of anaphylaxis or treatmentrelated death were found. Conclusions: The main causes of iron deficiency anemia are associated with upper gastrointestinal bleeding diseases, although half of the cases have more than one cause, including administration of harmful drugs to the gastrointestinal mucosa and polypharmacy. There is a low incidence of severe anaphylactic effects with a high level of security.

Palabras clave: Iron deficiency anemia iron dextran.

2014-12-18   |   590 visitas   |   Evalua este artículo 0 valoraciones

Vol. 15 Núm.3. Julio-Septiembre 2014 Pags. 95-102 Rev Hematol 2014; 15(3)