Administration of Intravenous Ferric Carboxymaltose in a Patient With Iron-Deficiency Anemia and Allergy to 2 Oral Iron Preparations

Iron deficiency is a common occurrence in the pediatric population, often leading to the development of anemia. The first line of treatment is oral iron administration for the resolution of anemia and replenishment of iron stores. Although rare, patients may present with allergic reactions to iron, which can limit treatment modalities. We present the case of a 14-month-old boy who presented with iron-deficiency anemia and demonstrated allergy to 2 oral iron formulations. Our institution developed a treatment plan that includes adding premedications and slowly titrating of the infusion rate for the administration of intravenous iron. The patient successfully tolerated 2 infusions without developing allergic reactions and experienced resolution of his iron-deficiency anemia. When patients with iron-deficiency anemia are allergic to oral iron formulations, their treatment options are limited. There are a few reports of effective desensitizations with intravenous ferric carboxymaltose in pediatric patients. Our successful experience may help guide other institutions with similar patients.