{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:00:42Z","timestamp":1791489642072,"version":"4.3.4"},"reference-count":33,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>(1) Background: Gastroesophageal reflux disease (GERD) can cause several complications as a result of the acidic pH over various cellular structures, which have been demonstrated and evaluated over time. Anemia can occur due to iron loss from erosions caused by acidic gastric content. In children, anemia has consequences that, in time, can affect their normal development. This study evaluates the presence of anemia as a result of pediatric gastroesophageal reflux disease. (2) Methods: 172 children were diagnosed with gastroesophageal reflux in the gastroenterology department of a regional children\u2019s hospital in northeast Romania by esophageal pH-metry and they were evaluated for presence of anemia. (3) Results: 23 patients with GERD from the studied group also had anemia, showing a moderate correlation (r = \u22120.35, p = 0.025, 95% confidence interval) and lower levels of serum iron were found in cases with GERD, with statistical significance (F = 8.46, p = 0.012, 95% confidence interval). (4) Conclusions: The results of our study suggest that there is a relationship between anemia or iron deficiency and gastroesophageal reflux due to reflux esophagitis in children, which needs to be further studied in larger groups to assess the repercussions on children\u2019s development.<\/jats:p>","DOI":"10.3390\/diagnostics13010063","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T07:02:12Z","timestamp":1672124532000},"page":"63","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Iron Deficiency Anemia in Pediatric Gastroesophageal Reflux Disease"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2640-8795","authenticated-orcid":false,"given":"Vasile Valeriu","family":"Lupu","sequence":"first","affiliation":[{"name":"Pediatrics Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9825-6711","authenticated-orcid":false,"given":"Ingrith","family":"Miron","sequence":"additional","affiliation":[{"name":"Pediatrics Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria Laura","family":"Buga","sequence":"additional","affiliation":[{"name":"Pediatrics Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Gavrilovici","sequence":"additional","affiliation":[{"name":"Pediatrics Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3018-8011","authenticated-orcid":false,"given":"Elena","family":"Tarca","sequence":"additional","affiliation":[{"name":"Department of Surgery II\u2014Pediatric Surgery, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1979-8174","authenticated-orcid":false,"given":"Anca","family":"Adam Raileanu","sequence":"additional","affiliation":[{"name":"Pediatrics Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3937-7425","authenticated-orcid":false,"given":"Iuliana Magdalena","family":"Starcea","sequence":"additional","affiliation":[{"name":"Pediatrics Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5690-8638","authenticated-orcid":false,"given":"Andrei Tudor","family":"Cernomaz","sequence":"additional","affiliation":[{"name":"3rd Medical Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Mocanu","sequence":"additional","affiliation":[{"name":"Pediatrics Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8147-3632","authenticated-orcid":false,"given":"Ancuta","family":"Lupu","sequence":"additional","affiliation":[{"name":"Pediatrics Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,26]]},"reference":[{"key":"ref_1","unstructured":"Kuipers, E.J. (2019). Gastroesophageal Reflux Disease (GERD) in Children. Encyclopedia of Gastroenterology, Academic Press. [2nd ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1111\/j.1572-0241.2006.00630.x","article-title":"The Montreal definition and classification of gastroesophageal reflux disease: A global evidence-based consensus","volume":"101","author":"Vakil","year":"2006","journal-title":"Am. J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1097\/MPG.0000000000001889","article-title":"Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition","volume":"66","author":"Rosen","year":"2018","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"107","DOI":"10.5223\/pghn.2019.22.2.107","article-title":"Diagnosis and Management of Gastroesophageal Reflux Disease in Infants and Children: From Guidelines to Clinical Practice","volume":"22","author":"Hauser","year":"2019","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_5","first-page":"100784","article-title":"Pediatric gastroesophageal reflux disease in primary care: Evaluation and care update","volume":"50","author":"Bingham","year":"2020","journal-title":"Curr. Probl. Pediatr. Adolesc. Health Care"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Moscheo, C., Licciardello, M., Samperi, P., La Spina, M., Di Cataldo, A., and Russo, G. (2022). New Insights into Iron Deficiency Anemia in Children: A Practical Review. Metabolites, 12.","DOI":"10.3390\/metabo12040289"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"20441","DOI":"10.1021\/acsomega.2c01833","article-title":"Iron Absorption: Factors, Limitations, and Improvement Methods","volume":"7","author":"Piskin","year":"2022","journal-title":"ACS Omega"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.5152\/tpa.2015.2337","article-title":"Iron deficiency anemia from diagnosis to treatment in children","volume":"50","year":"2015","journal-title":"Turk. Pediatr. Ars."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e12042","DOI":"10.1097\/MD.0000000000012042","article-title":"Correlation between esophageal pH-metry and esophagitis in gastroesophageal reflux disease in children","volume":"97","author":"Lupu","year":"2018","journal-title":"Medicine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1016\/j.gie.2008.09.022","article-title":"Esophageal-reflux monitoring","volume":"69","author":"Pandolfino","year":"2009","journal-title":"Gastrointest. Endosc."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Wong, E.C.C., Brugnara, C., Straseski, J.A., Kellogg, M.D., and Adeli, K. (2020). 2-Hematology tests. Pediatric Reference Intervals, Academic Press. [8th ed.].","DOI":"10.1016\/B978-0-12-817939-0.00002-5"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.coph.2017.10.013","article-title":"Pharmacological management of gastroesophageal reflux disease in infants: Current opinions","volume":"37","author":"Mansoor","year":"2017","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.nwh.2020.01.005","article-title":"Pathophysiology of Gastroesophageal Reflux Disease in Infants and Nonpharmacologic Strategies for Symptom Management","volume":"24","author":"Pados","year":"2020","journal-title":"Nurs. Women\u2019s Health"},{"key":"ref_14","first-page":"2045","article-title":"Gastroesophageal reflux in infants and children. When to reassure and when to go further","volume":"47","author":"Jones","year":"2001","journal-title":"Can. Fam. Physician"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.pedhc.2015.08.004","article-title":"Clinical Practice Guidelines for the Management of Gastroesophageal Reflux and Gastroesophageal Reflux Disease: 1 Year to 18 Years of Age","volume":"30","author":"Papachrisanthou","year":"2016","journal-title":"J. Pediatr. Health Care"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.pcl.2017.01.003","article-title":"Gastroesophageal Reflux Disease","volume":"64","author":"Mousa","year":"2017","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1097\/MPG.0000000000002280","article-title":"Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children: A Systematic Review","volume":"68","author":"Singendonk","year":"2019","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_18","unstructured":"Fish, J.D., Lipton, J.M., and Lanzkowsky, P. (2021). Chapter 4\u2014Nutritional anemias. Lanzkowsky\u2019s Manual of Pediatric Hematology and Oncology, Academic Press. [7th ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Lupu, V.V., Miron, I., Tarca, E., Trandafir, L.M., Anton-Paduraru, D.T., Moisa, S.M., Starcea, M., Cernomaz, A., Miron, L., and Lupu, A. (2022). Gastroesophageal Reflux in Children with Asthma. Children, 9.","DOI":"10.3390\/children9030336"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e27660","DOI":"10.1097\/MD.0000000000027660","article-title":"The relationship between gastroesophageal reflux disease and recurrent wheezing in children","volume":"100","author":"Lupu","year":"2021","journal-title":"Medicine"},{"key":"ref_21","first-page":"46","article-title":"Dental erosion as an indicator of gastroesophageal reflux disease","volume":"70","author":"Ellis","year":"2022","journal-title":"Gen. Dent."},{"key":"ref_22","first-page":"40","article-title":"Oral manifestations of gastroesophageal reflux disease in children","volume":"9","author":"Ignat","year":"2017","journal-title":"Rom. J. Oral Rehabil."},{"key":"ref_23","first-page":"1066","article-title":"Sandifer Syndrome: A Case Report","volume":"59","author":"Shrestha","year":"2021","journal-title":"JNMA J. Nepal Med. Assoc."},{"key":"ref_24","first-page":"e22810","article-title":"The Relationship Between Obstructive Sleep Apnea (OSA) and Gastroesophageal Reflux Disease (GERD) in Inpatient Settings: A Nationwide Study","volume":"14","author":"Mahfouz","year":"2022","journal-title":"Cureus"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1093\/tropej\/fmm080","article-title":"Prevalence of celiac disease, Helicobacter pylori and gastroesophageal reflux in patients with refractory iron deficiency anemia","volume":"54","author":"Fayed","year":"2008","journal-title":"J. Trop. Pediatr."},{"key":"ref_26","first-page":"e937255","article-title":"Columnar Metaplasia of the Esophagus Presenting as Iron Deficiency Anemia in Children with Neurologic Impairment or Congenital Esophageal Atresia","volume":"23","author":"Nair","year":"2022","journal-title":"Am. J. Case Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"222","DOI":"10.4240\/wjgs.v13.i3.222","article-title":"Paraesophageal hernia and iron deficiency anemia: Mechanisms, diagnostics and therapy","volume":"13","author":"Dietrich","year":"2021","journal-title":"World J. Gastrointest. Surg."},{"key":"ref_28","first-page":"533","article-title":"Anemia ipocromica iposideremica come primo sintomo di reflusso gastroesofageo [Hypochromic hyposideremic anemia as the first symptom of gastroesophageal reflux]","volume":"11","author":"Massolo","year":"1989","journal-title":"Pediatr. Med. Chir."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Rybak, A., Pesce, M., Thapar, N., and Borrelli, O. (2017). Gastro-Esophageal Reflux in Children. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18081671"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1080\/10245330600775105","article-title":"Iron deficiency in childhood and adolescence: Retrospective review","volume":"11","author":"Ferrara","year":"2006","journal-title":"Hematology"},{"key":"ref_31","unstructured":"Patil, S., and Tas, V. (2022). Sandifer Syndrome, StatPearls."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3928\/00904481-20131223-05","article-title":"A 6-month-old boy with uncontrollable dystonic posture of the neck. Sandifer syndrome","volume":"43","author":"Cafarotti","year":"2014","journal-title":"Pediatr. Ann."},{"key":"ref_33","first-page":"18","article-title":"Sandifer syndrome","volume":"31","author":"Moore","year":"2018","journal-title":"JAAPA Off. J. Am. Acad. Physician Assist."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/1\/63\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:51:25Z","timestamp":1760147485000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/1\/63"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,26]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["diagnostics13010063"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13010063","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,26]]}}}