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Background: Patients with bleeding disorders have greater propensity for blood loss and therefore may have a higher prevalence of iron deficiency (ID) when compared to the general population. However, current literature focuses on adolescent females and few studies have assessed the overall prevalence of ID in children with inherited bleeding disorders. Aims: This study aims to identify the prevalence of ID in children with an inherited bleeding disorder. Methods: A retrospective analysis of children with any inherited bleeding disorder seen in Children’s Mercy Hospital’s Hemophilia Treatment Center between 2010 and 2020 was performed. Iron deficiency was defined by recently published serum ferritin thresholds outlined by the National Health and Nutrition Examination Surveys. Results: There were 798 patients with inherited bleeding disorders who were included in this analysis. Of the 306 patients who had serum ferritin collected, 162 (53%) had ID. In patients who had ID, 68% were female and 48% were aged 6 to 15 years. Notably, of the 129 (26%) males with serum ferritin collected, 40% had ID. The proportion of patients who had ID in each age group is displayed in figure 1. Of the 757 patients who had blood counts measured, 346 (46%) were anemic. Of the patients with anemia, 232 (67%) were male. The proportion of anemic patients in each age group is displayed in figure 2. Conclusion: The prevalence of ID in children in our cohort is considerably higher than the 10% prevalence estimated in the general pediatric population. Prior epidemiologic analysis of ID and iron deficiency anemia is mostly focused on adolescent females. However, the high prevalence of anemia in males with inherited bleeding disorders suggests that they are at comparable risk. Considering only 24% of males had ferritin collected, it is possible that the prevalence of ID in males is higher than this report suggests.




Presented at the 2023 Congress of the International Society on Thrombosis and Haemostasis; Montreal, Quebec, Canada. June 24-28, 2023.

Prevalence of Iron Deficiency in Patients with Inherited Bleeding Disorders

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