Letter to the Editor: TREATMENT OF IRON DEFICIENCY ANEMIA

The article by Dr. Kavaklı and his colleagues [1] about the treatment of iron-deficiency anemia in children supports our findings that response to ferrous sulfate is much better than the response to ferripolymaltose complexes [2].

The authors mentioned that at the end of the study, ferritin levels were higher than 20 ng/mL in the patients who were treated with ferro or ferric iron complexes. In spite of normal ferritin levels in both groups, lower hemoglobin levels in the ferripolymaltose group would be an indication of decreased bioavalability of iron in this group, as was concluded by us [2]. However, the authors' statement that all patients in both groups had Hb levels higher than 11 g/dL was not fitting to their Table 1 findings, since in the Fe³⁺ group Hbs (mean ± SD) was 11.4 ± 1.1 and 11.4 ± 1.2 g/dL at the third and sixth months of treatment. These values would indicate that Hb was lower than 11 g/dL in some of the children, which needs clarifacation.

More importantly, catalase levels do not fit to our earlier study that this enzyme activity is lower in iron deficiency (iron deficiency and iron-deficiency anemia) [3]. This most likely is due to relating this enzyme activity to Hb level by the authors. Catalase activity is function of cell (erythrocytes or other cells), not Hb. I have been calling attention to this discrepancy since 1964, but have not been effective in changing this way of presenting the data [[4], [5], [6]].