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Addition of Cobalamin to Iron and Folic Acid Improves Hemoglobin Rise in Nutritional Anemia

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Abstract

Objective

To assess whether addition of cobalamin (cbl) to iron-folic acid will result in improved response in nutritional anemia.

Methods

This study included 150 children aged between 0.5–5 y having nutritional anemia. Anemia was categorized for severity and red cell morphology. Serum levels of ferritin were obtained in all cases while levels of cbl and folic acid (FA) were done only in children having macrocytic or dimorphic anemia. Children were randomized to receive either iron and FA (Group I) or iron, FA and cbl (Group II). Response to treatment was assessed at 2, 4 and 8 wk.

Results

Of all the 150 patients, iron deficiency was documented in 111 patients. Of the 41 cases in whom, Cbl and FA levels were done, 97.56% and 53.66% had deficiency of cbl and FA respectively. Patients in group II had higher Hb level at 2, 4 and 8 wk (significant at 4 and 8 wk). Percentage Hb rise from baseline Hb was significantly higher in group II (p 0.00). In group II, increase in Hb among cases with macrocytosis and others were similar although percentage increase in Hb was more pronounced among patients with macrocytic anemia or dimorphic anemia. However, this difference was statistically not significant (p = 0.18).

Conclusions

Children receiving cbl in addition to iron and FA showed an improved hematological response.

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Abbreviations

MA:

Megaloblastic anemia

Cbl:

Cobalamin

FA:

Folic acid

Hb:

Hemoglobin

M:

Male

F:

Female

SD:

Standard deviation

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Contributions

SC, SS, SM: acquisition of data, literature review, investigations and interpretation of data; JC: conceptualized the study, drafted the article, guarantor; SN, SA, HMC: revised the study and helped in drafting the article and final approval.

Conflict of Interest

None.

Role of Funding Source

None.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children’s Hospital, New Delhi, India

    Sudha Chandelia, Jagdish Chandra & Satinder Aneja

  2. Department of Pathology, Lady Hardinge Medical College and Associated Kalawati Saran Children’s Hospital, New Delhi, India

    Shashi Narayan & Sunita Sharma

  3. Department of Chemistry, Indian Institute of Technology, New Delhi, India

    Har Mohindra Chawla & Sarika Mrig

  4. 28, Tekhand, Okhla Industrial Area, Phase −1, New Delhi, 110020, India

    Sudha Chandelia

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  1. Sudha Chandelia
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  2. Jagdish Chandra
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  4. Satinder Aneja
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  5. Har Mohindra Chawla
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  6. Sunita Sharma
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Correspondence to Sudha Chandelia.

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Chandelia, S., Chandra, J., Narayan, S. et al. Addition of Cobalamin to Iron and Folic Acid Improves Hemoglobin Rise in Nutritional Anemia. Indian J Pediatr 79, 1592–1596 (2012). https://doi.org/10.1007/s12098-012-0725-9

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  • DOI: https://doi.org/10.1007/s12098-012-0725-9

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