• Rodolfo Delfini Cançado, Sérgio Augusto Buzian Brasil, Tatiana Gomes Noronha, and Carlos Sérgio Chiattone.
• Departamento de Clínica Médica, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP. rdcan@uol.com.br
• Rev Assoc Med Bras. 2005 Nov 1;51(6):323-8.

ObjectiveTo evaluate the efficacy of intravenous iron III-hydroxide saccharate for treating adult patients with iron deficiency anemia lacking satisfactory response to oral iron therapy.MethodsBetween January 2003 and January 2004, 25 patients with iron deficiency anemia who presented intolerance or inadequate response to iron oral therapy, or hemoglobin level < 7 g/dl were studied. The main laboratory tests performed were: complete blood cell count, reticulocyte count, serum iron, total iron-binding capacity, serum ferritin. Patients received a weekly dose of 200 mg of iron diluted in 250 mL of 0.9% sodium chloride solution administered intravenously for 30 minutes. Treatment continued until a hemoglobin level = 12 g/dL for women and = 13 g/dL for men were obtained or until full administration of the total dose of parenteral iron recommended for each patient.ResultsMedian age of the patients studied was 45 years (ages ranging from 31 to 70). Nineteen out of 25 patients (76%) were women. The most common cause of iron deficiency anemia was abnormal uterine bleeding observed in 68% of the female patients (13 out of 19) and partial gastrectomy observed in 67% of the male patients (4 out of 6). Seventeen (68%) patients were included in this study because they did not respond to oral iron therapy, 24% (6 out of 25) showed intolerance to oral iron and 8% (2 out of 25) presented hemoglobin level < 7 g/dl. Correction of anemia was obtained in 12 out of 19 female patients (63%) and in 5 out of 6 male patients (83%). The mean hemoglobin and ferritin values were 8.09 g/dl and 4.20 ng/ml (pre-treatment) and 12.42 g/dl and 87.78 ng/ml (post-treatment) (p < 0.001), respectively. The average increase of hemoglobin was 3.74 g/dl, ranging from 1.30 to 7.60 g/dl. None of the patients received blood transfusion during or after the intravenous iron treatment.ConclusionThe use of intravenous iron III-hydroxide saccharate is an efficacious and safe option in the treatment of adult patients with iron deficiency anemia lacking satisfactory response to oral iron therapy. This option of treatment should be considered mainly for patients with severe anemia in order to obtain rapid increase of the hemoglobin level and avoid blood transfusion.

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