ABSTRACT. A 3-year-old child was referred to consultation for hyperactivity, attention deficit, impulsivity, and sleep problems. He met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for attentiondeficit/hyperactivity disorder. At baseline, the Conners' Parent Rating Scale and the Conners' Teacher Rating Scale raw total scores were 30 and 32, respectively. The child had low a serum ferritin level (13 ng/mL). After 8 months of treatment with Tardyferon (ferrous sulfate, 80 mg/day), his serum ferritin increased to 102 ng/mL. Both parents and teachers reported considerable behavioral improvement. The Conners' Parent and Teacher Rating Scale raw total scores decreased to 19 and 13, respectively. This is the first report of the effectiveness of iron supplementation in a young child with attention-deficit/hyperactivity disorder. P reliminary evidence supports a significant iron deficiency in children with attention-deficit/ hyperactivity disorder (ADHD). 1 The symptoms of ADHD may be related to a dopamine dysfunction or to an imbalance in dopaminergic function. [2][3][4][5] Iron is a cofactor for tyrosine hydroxylase, the rate-limiting enzyme for dopamine synthesis. Moreover, iron deficiency has been described to alter dopamine D 1 and D 2 receptor density and activity in animals. 6,7 Therefore, brain iron stores might influence dopamine-dependent functions and, consequently, the expression of ADHD symptoms.Previous neuropsychological studies reported an improvement in children' s attention span after iron supplementation. 8,9 However, no study thus far has addressed specifically the effectiveness of iron supplementation in iron-deficient children with ADHD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. 10 This study reports on the effect of iron supplementation in a 3-year-old child with ADHD.
CASE REPORTA 3-year-old male was referred to the outpatient clinic of the child psychopathology unit for symptoms of inattention, hyperactivity, and impulsivity at school and home.His father, a 28-year-old-employee, presented with symptoms of inattention and impulsivity. In childhood, he also was hyperactive. These symptoms caused a functional impairment first at school and subsequently in his work and social life. Therefore, the father was very worried about the symptomatology presented by his son. The mother, a 29-year-old housewife, reported no relevant psychiatric symptoms. The child was the only son in the family. No other relevant psychiatric symptoms or disorders in the family were reported. No medical problems during pregnancy or after the birth of the child were reported. The physical and neurologic development of the child was normal. At the time of the consultation, the child was in his first year of kindergarten. After consultation with the teachers, who also were very worried about the behavior of the child at school, the parents decided to come to our unit.Although the diagnosis of ADHD in preschoolers is complex an...