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Comparison between oral ferrous sulfate and intravenous ferric carboxymaltose in children with restless sleep disorder (RSD)
Sleep ( IF 5.6 ) Pub Date : 2020-08-25 , DOI: 10.1093/sleep/zsaa155
Lourdes M DelRosso 1 , Daniel L Picchietti 2 , Raffaele Ferri 3
Affiliation  

STUDY OBJECTIVES Recent work has identified clinical and polysomnographic features of a newly defined pediatric sleep disorder, restless sleep disorder (RSD). One of these features is low serum ferritin. In this retrospective, pilot study, we assess the response to iron supplementation. Children were given oral ferrous sulfate (FS) or intravenous ferric carboxymaltose (IV FCM). METHODS Children 5-18 years old with a diagnosis of RSD were evaluated clinically. Serum ferritin, iron profile, and video-polysomnography were obtained at baseline. Oral or IV iron supplementation was offered as part of routine care. Oral FS was one 325 mg tablet daily or 3 mg/kg/day liquid for 3 months. IV FCM was 15 mg/kg, up to 750 mg as a single infusion. Adverse effects were assessed. Ferritin and iron profile were checked after 2-3 months. Eight weeks after FCM, phosphorus level was checked. Clinical Global Impression Scale (CGI) was obtained pre- and posttreatment. RESULTS Fifteen children received oral FS and 15 IV FCM. Baseline RSD severity, age, gender or pretreatment lab values did not differ significantly between groups. CGI-Improvement median score was "minimally improved" after oral FS and "much improved" after IV FCM. All iron parameters were found to be significantly higher after intravenous iron treatment than oral iron. Adverse effects: constipation, 3 with FS; noncompliance, 1 with FS; syncope, 1 with FCM infusion; and hypophosphatemia, 0 post-FCM. CONCLUSIONS In this retrospective, clinical case series, RSD responded to iron supplementation with improvement in both clinical and laboratory parameters. The response was greater with IV FCM than oral FS.

中文翻译:

儿童不安睡眠障碍(RSD)口服硫酸亚铁与静脉注射羧基麦芽糖铁的比较

研究目标 最近的工作已经确定了一种新定义的儿科睡眠障碍——不安睡眠障碍 (RSD) 的临床和多导睡眠图特征。这些特征之一是低血清铁蛋白。在这项回顾性、试点研究中,我们评估了对铁补充剂的反应。给儿童口服硫酸亚铁 (FS) 或静脉注射羧基麦芽糖铁 (IV FCM)。方法 对诊断为 RSD 的 5-18 岁儿童进行临床评估。在基线时获得血清铁蛋白、铁谱和视频多导睡眠图。作为日常护理的一部分,提供口服或静脉补铁。口服 FS 是每天一片 325 毫克片剂或 3 毫克/公斤/天液体,持续 3 个月。IV FCM 为 15 mg/kg,单次输注高达 750 mg。评估了不良反应。2-3 个月后检查铁蛋白和铁谱。FCM 八周后,检查磷水平。在治疗前和治疗后获得临床总体印象量表(CGI)。结果 15 名儿童接受了口服 FS 和 15 名 IV FCM。基线 RSD 严重程度、年龄、性别或治疗前实验室值在各组之间没有显着差异。CGI-Improvement 中值评分在口服 FS 后“改善微乎其微”,而在 IV FCM 后“改善很多”。发现静脉铁剂治疗后所有铁参数显着高于口服铁剂。不良反应:便秘,3同FS;不符合,1 与 FS;晕厥,1 次 FCM 输注;和低磷血症,0 后 FCM。结论 在这个回顾性临床病例系列中,RSD 对补铁有反应,临床和实验室参数均有所改善。与口服 FS 相比,IV FCM 的反应更大。
更新日期:2020-08-25
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