The Effect of Ferric Carboxymaltose on Fibroblast Growth Factor 23 (FGF23) in Children with Iron Deficiency Anemia Due to Gastrointestinal Diseases

<b>Background:</b> Hypophosphatemia is a known side-effect of parenteral iron administration, especially after intravenous ferric carboxymaltose (FCM). Fibroblast growth factor 23 (FGF23) is thought to play an important role in the pathophysiology of serum phosphate homeostasis. This stu...

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Main Authors: Maria Ntoumpara, Elpis Mantadakis, Lemonia Skoura, Paraskevi Panagopoulou, Elpida Emmanouilidou-Fotoulaki, Eleftheria Parasidou, Paraskevoula Koutra, Maria Fotoulaki
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Language:English
Published: MDPI AG 2024-11-01
Series:Hemato
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Online Access:https://www.mdpi.com/2673-6357/5/4/34
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author Maria Ntoumpara
Elpis Mantadakis
Lemonia Skoura
Paraskevi Panagopoulou
Elpida Emmanouilidou-Fotoulaki
Eleftheria Parasidou
Paraskevoula Koutra
Maria Fotoulaki
author_facet Maria Ntoumpara
Elpis Mantadakis
Lemonia Skoura
Paraskevi Panagopoulou
Elpida Emmanouilidou-Fotoulaki
Eleftheria Parasidou
Paraskevoula Koutra
Maria Fotoulaki
author_sort Maria Ntoumpara
collection DOAJ
description <b>Background:</b> Hypophosphatemia is a known side-effect of parenteral iron administration, especially after intravenous ferric carboxymaltose (FCM). Fibroblast growth factor 23 (FGF23) is thought to play an important role in the pathophysiology of serum phosphate homeostasis. This study aimed to investigate the effects of FCM on FGF23 serum levels in FCM-treated pediatric patients with iron deficiency (ID)/iron deficiency anemia (IDA) caused by gastrointestinal diseases. <b>Methods:</b> Over 30 months, FGF23 serum levels were assessed prospectively in children with ID/IDA due to gastrointestinal diseases and treated with FCM infusion. Serum levels of intact FGF23 (iFGF23) were assessed and correlated to phosphate serum levels and factors of bone metabolism. Blood sampling was performed in three phases: before FCM infusion, 7–10 days after FCM infusion, and 6–8 weeks after FCM infusion. <b>Results:</b> A total of 42 FCM infusions were given to 35 children (20 girls) with a mean age (±SD) of 12.2 (±4.03) years (range: 2–16 years). The median levels of iFGF23 did not show a significant difference across the three phases (<i>p</i> = 0.56). No significant correlation was found between iFGF23 levels and 25-hydroxyvitamin D/parathyroid hormone/serum phosphate/serum calcium/alkaline phosphatase. No significant change was noted between pre- and post-treatment serum phosphate levels. However, four children (11.42%) developed asymptomatic and transient hypophosphatemia. <b>Conclusions:</b> No significant difference was found between pre-and post-FCM infusion serum iFGF23 levels and bone metabolism parameters. An increase of iFGF23 serum levels 7–10 days after FCM infusion was noted in patients with hypophosphatemia.
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spelling doaj-art-11f3cb163fb04400a03db0ca7ed647242025-08-20T02:55:57ZengMDPI AGHemato2673-63572024-11-015444845810.3390/hemato5040034The Effect of Ferric Carboxymaltose on Fibroblast Growth Factor 23 (FGF23) in Children with Iron Deficiency Anemia Due to Gastrointestinal DiseasesMaria Ntoumpara0Elpis Mantadakis1Lemonia Skoura2Paraskevi Panagopoulou3Elpida Emmanouilidou-Fotoulaki4Eleftheria Parasidou5Paraskevoula Koutra6Maria Fotoulaki74th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital, 56403 Thessaloniki, GreeceDepartment of Pediatrics, Democritus University of Thrace, Faculty of Medicine, University General Hospital of Alexandroupolis, 68100 Alexandroupolis, GreeceDepartment of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital, 56403 Thessaloniki, Greece4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital, 56403 Thessaloniki, GreeceDepartment of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, GreeceDepartment of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital, 56403 Thessaloniki, Greece<b>Background:</b> Hypophosphatemia is a known side-effect of parenteral iron administration, especially after intravenous ferric carboxymaltose (FCM). Fibroblast growth factor 23 (FGF23) is thought to play an important role in the pathophysiology of serum phosphate homeostasis. This study aimed to investigate the effects of FCM on FGF23 serum levels in FCM-treated pediatric patients with iron deficiency (ID)/iron deficiency anemia (IDA) caused by gastrointestinal diseases. <b>Methods:</b> Over 30 months, FGF23 serum levels were assessed prospectively in children with ID/IDA due to gastrointestinal diseases and treated with FCM infusion. Serum levels of intact FGF23 (iFGF23) were assessed and correlated to phosphate serum levels and factors of bone metabolism. Blood sampling was performed in three phases: before FCM infusion, 7–10 days after FCM infusion, and 6–8 weeks after FCM infusion. <b>Results:</b> A total of 42 FCM infusions were given to 35 children (20 girls) with a mean age (±SD) of 12.2 (±4.03) years (range: 2–16 years). The median levels of iFGF23 did not show a significant difference across the three phases (<i>p</i> = 0.56). No significant correlation was found between iFGF23 levels and 25-hydroxyvitamin D/parathyroid hormone/serum phosphate/serum calcium/alkaline phosphatase. No significant change was noted between pre- and post-treatment serum phosphate levels. However, four children (11.42%) developed asymptomatic and transient hypophosphatemia. <b>Conclusions:</b> No significant difference was found between pre-and post-FCM infusion serum iFGF23 levels and bone metabolism parameters. An increase of iFGF23 serum levels 7–10 days after FCM infusion was noted in patients with hypophosphatemia.https://www.mdpi.com/2673-6357/5/4/34iron deficiencyiron deficiency anemiaparenteral ironferric carboxymaltosefibrobast growth factor 23hypophosphatemia
spellingShingle Maria Ntoumpara
Elpis Mantadakis
Lemonia Skoura
Paraskevi Panagopoulou
Elpida Emmanouilidou-Fotoulaki
Eleftheria Parasidou
Paraskevoula Koutra
Maria Fotoulaki
The Effect of Ferric Carboxymaltose on Fibroblast Growth Factor 23 (FGF23) in Children with Iron Deficiency Anemia Due to Gastrointestinal Diseases
Hemato
iron deficiency
iron deficiency anemia
parenteral iron
ferric carboxymaltose
fibrobast growth factor 23
hypophosphatemia
title The Effect of Ferric Carboxymaltose on Fibroblast Growth Factor 23 (FGF23) in Children with Iron Deficiency Anemia Due to Gastrointestinal Diseases
title_full The Effect of Ferric Carboxymaltose on Fibroblast Growth Factor 23 (FGF23) in Children with Iron Deficiency Anemia Due to Gastrointestinal Diseases
title_fullStr The Effect of Ferric Carboxymaltose on Fibroblast Growth Factor 23 (FGF23) in Children with Iron Deficiency Anemia Due to Gastrointestinal Diseases
title_full_unstemmed The Effect of Ferric Carboxymaltose on Fibroblast Growth Factor 23 (FGF23) in Children with Iron Deficiency Anemia Due to Gastrointestinal Diseases
title_short The Effect of Ferric Carboxymaltose on Fibroblast Growth Factor 23 (FGF23) in Children with Iron Deficiency Anemia Due to Gastrointestinal Diseases
title_sort effect of ferric carboxymaltose on fibroblast growth factor 23 fgf23 in children with iron deficiency anemia due to gastrointestinal diseases
topic iron deficiency
iron deficiency anemia
parenteral iron
ferric carboxymaltose
fibrobast growth factor 23
hypophosphatemia
url https://www.mdpi.com/2673-6357/5/4/34
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