{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:09:17Z","timestamp":1773274157432,"version":"3.50.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Iron deficiency anemia (IDA) is a leading cause of anemia worldwide, often managed with oral iron. Severe paediatric cases, however, raise uncertainty about when to use packed red blood cell (pRBC) transfusion versus intravenous (IV) iron. We report a 16-year-old male with autism spectrum disorder and severe nutritional IDA (hemoglobin 31\u2005g\/L) who presented with tachycardia and hypotension but no acute decompensation. Although transfusion was discussed, the patient declined, and he was managed with IV iron followed by oral supplementation. Hemoglobin recovery was brisk, rising by 13\u2005g\/L within 5 days, but functional recovery was slow, taking 6 months. This case highlights the therapeutic dilemma in adolescents with chronic severe IDA who may meet criteria for transfusion yet remain clinically stable. IV iron offers a viable alternative in this setting, but paediatric guidelines are needed to better define transfusion thresholds and the role of IV iron.<\/jats:p>","DOI":"10.1093\/pch\/pxaf091","type":"journal-article","created":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T11:42:00Z","timestamp":1757763720000},"page":"95-97","source":"Crossref","is-referenced-by-count":0,"title":["Navigating treatment dilemmas in severe paediatric IDA: A case report"],"prefix":"10.1093","volume":"31","author":[{"given":"Rachel","family":"Fagen","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Ottawa, Ottawa, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Howard","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4661-9792","authenticated-orcid":false,"given":"Matthew","family":"Speckert","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"issue":"9","key":"2026031105403051200_pxaf091-B1","doi-asserted-by":"crossref","first-page":"e713","DOI":"10.1016\/S2352-3026(23)00160-6","article-title":"Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990\u20132021: Findings from the Global Burden of Disease Study 2021","volume":"10","author":"Gardner","year":"2023","journal-title":"Lancet Haematol"},{"issue":"2","key":"2026031105403051200_pxaf091-B2","first-page":"98","article-title":"Iron deficiency anemia: Evaluation and management","volume":"87","author":"Short","year":"2013","journal-title":"Am Fam Physician"},{"issue":"3","key":"2026031105403051200_pxaf091-B3","doi-asserted-by":"crossref","first-page":"e30181","DOI":"10.1002\/pbc.30181","article-title":"Management of nutritional iron deficiency anemia for young children in the emergency department","volume":"70","author":"McEvoy","year":"2023","journal-title":"Pediatr Blood Cancer"},{"issue":"4","key":"2026031105403051200_pxaf091-B4","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.hoc.2014.04.007","article-title":"Diagnosis and management of iron deficiency anemia","volume":"28","author":"Powers","year":"2014","journal-title":"Hematol Oncol Clin North Am"},{"issue":"19","key":"2026031105403051200_pxaf091-B5","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1001\/jama.2023.12914","article-title":"Red blood cell transfusion: 2023 AABB international guidelines","volume":"330","author":"Carson","year":"2023","journal-title":"JAMA"},{"issue":"2","key":"2026031105403051200_pxaf091-B6","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1182\/bloodadvances.2020003635","article-title":"The ASH-ASPHO choosing wisely campaign: 5 hematologic tests and treatments to question","volume":"6","author":"O\u2019Brien","year":"2022","journal-title":"Blood Adv"},{"key":"2026031105403051200_pxaf091-B7"},{"issue":"1","key":"2026031105403051200_pxaf091-B8","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1093\/pch\/pxac095","article-title":"Severe iron deficiency anemia in the paediatric emergency department: A retrospective study","volume":"28","author":"Speckert","year":"2023","journal-title":"Paediatr Child Health"},{"issue":"1","key":"2026031105403051200_pxaf091-B9","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1182\/asheducation-2016.1.57","article-title":"Single-dose intravenous iron for iron deficiency: A new paradigm","volume":"2016","author":"Auerbach","year":"2016","journal-title":"Hematol Am Soc Hematol Educ Program"},{"key":"2026031105403051200_pxaf091-B10","author":"Boucher"},{"key":"2026031105403051200_pxaf091-B11","doi-asserted-by":"crossref","first-page":"113878","DOI":"10.1016\/j.jpeds.2023.113878","article-title":"Hemoglobin threshold for blood transfusion in young children hospitalized with iron deficiency anemia","volume":"266","author":"Sun","year":"2024","journal-title":"J Pediatr"},{"key":"2026031105403051200_pxaf091-B12","author":"Callum"},{"issue":"7","key":"2026031105403051200_pxaf091-B13","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1002\/ajh.27220","article-title":"Expert consensus guidelines: Intravenous iron uses, formulations, administration, and management of reactions","volume":"99","author":"Van Doren","year":"2024","journal-title":"Am J Hematol"},{"issue":"1","key":"2026031105403051200_pxaf091-B14","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1182\/hematology.2019000034","article-title":"Management of iron deficiency","volume":"2019","author":"Ning","year":"2019","journal-title":"Hematology"},{"issue":"4","key":"2026031105403051200_pxaf091-B15","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.transci.2018.05.026","article-title":"Extreme anemia (Hb 33\u2005g\/L) in a 13-year-old girl: Is the transfusion always mandatory?","volume":"57","author":"Beverina","year":"2018","journal-title":"Transfus Apher Sci"}],"container-title":["Paediatrics &amp; Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pch\/article-pdf\/31\/2\/95\/66377983\/pxaf091.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pch\/article-pdf\/31\/2\/95\/66377983\/pxaf091.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T09:40:43Z","timestamp":1773222043000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pch\/article\/31\/2\/95\/8422831"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1,12]]},"published-print":{"date-parts":[[2026,3,11]]}},"URL":"https:\/\/doi.org\/10.1093\/pch\/pxaf091","relation":{},"ISSN":["1205-7088","1918-1485"],"issn-type":[{"value":"1205-7088","type":"print"},{"value":"1918-1485","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,1,12]]}}}