Anaemia

Question

My son was diagnosed severe CF form from birth. A few times he was at
ICU for ventilation. Now he is 1 year old, very active, his weight is 8,650 kg, but was some suspicion that he has anemia. We used some iron preparations (feroglobine) as well as apple or beetroot juice.
How to treat anemia and crackles in the lungs?

Answer

Dear Questioner,
anaemia in CF can have many reasons, one of it may be an iron deficiency due to inadequate dietary intake, malabsorption, and blood loss. Pancreatic enzymes may be responsible for impaired oral iron absorption and iron should not be supplemented in close proximity to pancreatic enzyme supplements. Especially if the patient was a preterm baby, an iron deficiency is likely. If an anemia has been diagnosed, it is important to prove that it is a real iron deficiency (by investigating not only iron, but also transferring and ferritin in the blood) and that it is not only due to chronic infection (which should be treated rigorously). Our policy is to treat overt iron deficient anemia, but we tend not to give iron at the earlier stages of reduced stores due to concerns over its GI side effects. On the other hand, iron is important for the development of the brain in young children. When necessary we use liquid iron for children 1-5 year old.
Blood test should be checked after 2- 3 months of treatment.
Crackles is most common finding in CF lung disease which should be treated by your CF doctor using various methods- antibiotics, mucolytics, physiotherapy.

Regards,
Sigitas Dumčius

15.04.2010