Iron Status of Multiple Transfused Sickle Cell Anaemia Patients Attending a Sickle Cell Clinic in Benin City, Nigeria

Ikusemoro, A. I.; Halim, Nkd; Awodu, OA; Ehiaghe, F. A.; Isoa, EM; Ehiaghe, I. J.

doi:10.4236/ojpathology.2014.42005

Cited by 6 publications

(11 citation statements)

References 16 publications

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“…The lower red cell production due of lack of iron appeared to have compensated by the improvement in red cell survival. The indices of iron status observed in our study were lower than that reported in multiple transfused SCD patients [26] . They reported that increased levels of iron, TS, and decreased TIBC in multiple transfused SCD patients suggests an increase in iron stores and the patients may be at risk of developing iron overload [26] .…”

Section: Discussioncontrasting

confidence: 96%

“…The indices of iron status observed in our study were lower than that reported in multiple transfused SCD patients [26] . They reported that increased levels of iron, TS, and decreased TIBC in multiple transfused SCD patients suggests an increase in iron stores and the patients may be at risk of developing iron overload [26] . None of our studied subjects had transfusion within the last 3months prior to blood collection.…”

Section: Discussioncontrasting

confidence: 96%

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Indices of Iron status are nearer to normal levels in foetal haemoglobin persistent Sickle cell anaemia compared to the sickle cell anaemia with low foetal haemoglobin

Ma¹,

Mh²,

Bi³

2017

J. Med. Res.

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Background: Foetal haemoglobin (HbF) is a major regulator of the haematologic and clinical features of Sickle cell anaemia (SCA). This study examines the frequency of high HbF concentration and its effect on the levels of indices of iron status in adult SCA subjects on steady clinical state. Materials and Methods: Iron, total iron binding capacity (TIBC), percentage transferrin saturation (TS), HbF and full blood count were determined in adult sickle cell disease and control subjects using spectrophotometric method and haematology analyzer. Results: One hundred (100) adults with SCA on steady clinical state and 50 with normal haemoglobin were recruited for the study. Out of the 100 SCA subjects, 25(25%) had hereditary persistent HbF (HPFH) (≥5%). Serum iron and TS were significantly lower (p<0.001) in SCA subjects compared with controls, while mean TIBC and HbF were significantly higher (p<0.001) in SCA subjects than controls. The mean serum iron and TS were significantly higher (p<0.001) in HPFH SCA subjects compared to SCA subjects with low (≤4.9%) HbF concentrations, while TIBC was significantly lower (p<0.001) in HPFH SCA subjects than those with low HbF concentrations. Conclusion: The indices of iron status were near normal levels in HPFH SCA compared to the levels in SCA with low HbF which may due to increased haemoglobin, relative decrease in intravascular haemolysis and urinary loss of iron. The proportion of SCD subjects with HPFH as observed was 25%. It is suggested that iron status in SCA subjects should be done routinely.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussioncontrasting

confidence: 96%

Indices of Iron status are nearer to normal levels in foetal haemoglobin persistent Sickle cell anaemia compared to the sickle cell anaemia with low foetal haemoglobin

Ma¹,

Mh²,

Bi³

2017

J. Med. Res.

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“…[15] In our study, serum ferritin values in transfused patients were significantly higher than those in nontransfused patients, which was statistically significant (P < 0.0000001). In addition, 48.6% of subjects in our study who received blood transfusion and 16.1% of subjects who did not receive blood transfusion showed increased serum ferritin levels .This result is well correlated with the study by Patra et al [14] in which 75% transfused patients and 16% nontransfused patients showed increased serum ferritin levels, and the study done by Ikusemoro et al [2] showed a positive correlation between serum ferritin and number of units of blood transfused (r = 0.719, P = 0.0000) with a linear increase in serum ferritin levels seen in cumulative transfusions. However, in the study done by Akinbami et al, [16] 2% of patients who revealed history of blood transfusion showed increased serum ferritin levels, while 90% of the patients showed serum ferritin within normal reference range.…”

Section: Discussionsupporting

confidence: 92%

“…Sickle cell disorders (SCDs) that are characterized by the presence of hemoglobin S (HbS) in red cells [1] refer to a group of disorders caused by autosomal recessive inheritance of a pair of abnormal hemoglobin genes, including the sickle cell gene. [2] In HbS (β6 glu→val), the glutamic acid in the sixth position on the β-chain is replaced by valine. [3][4][5] SCD comprises especially in the tropics, include poor nutrition and parasitic infestations and varying bacterial infections, which may disturb iron metabolism.…”

Section: Introductionmentioning

confidence: 99%

Iron status in sickle cell disorders

Patel¹,

Jha²,

Jana³

et al. 2016

Int J Med Sci Public Health

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Background: There is a general view that patients with sickle cell disease (SCD) reveal iron overload and that iron deficiency anemia is uncommon in them because of the availability of an adequate iron source from increased red cell turnover and blood transfusions. However, there are reports of iron deficiency in a proportion of these patients, which can often be missed because they exhibit already anemic condition. Objective: To evaluate the iron status and to determine the incidence of iron deficiency in sickle cell disorders including subjects with SCD, sickle cell trait (SCT), and compound heterozygosity. Materials and Methods: A total of 155 subjects were included in study; 138 of these showed homozygous sickle cell anemia (SS) and 17 sickle cell trait (AS). Presence of HbS was detected by solubility test, followed by hemoglobin phenotype determination by automated HPLC. The measurement of serum iron and total iron-binding capacity was done by ferrozine method, serum ferritin by radioimmunoassay, and zinc protoporphyrin (ZPP) by using ProtoFluor-Z Hematofluorimeter, while hematological parameters were determined using a Sysmex Kx21 autoanalyzer. Result: Of the 155 patients studied, 7 (4.5%) showed iron deficiency and 33 (21.3%) showed iron overload. Iron and serum ferritin values in transfused patients were significantly higher than in nontransfused patients. The mean reticulocyte count was significantly lower in iron deficient group than that in iron sufficient group. The ZPP values were elevated in all iron deficient and the 39 of 148 iron sufficient/overloaded subjects; however, ZPP values were much higher in the iron deficiency group. Conclusion: A state of iron deficiency may be present in SCD and SCT patients. Therefore, we recommend that patients with SCD and SCT should be screened for iron deficiency by conventional laboratory tests.

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“…Kassim et al [11] found that serum iron values were more in transfused patients as compared to non-transfused patients. The study done by Ikusemoro et al [12] showed a positive correlation between serum ferritin and number of units of blood transfused with a linear increase in serum ferritin levels seen in cumulative transfusions. The study conducted by Das PK and Sarangi A et al [13] also found high serum ferritin levels in 15.4% of Sickle cell anaemia patients, which was well correlated to the number of blood transfusion.…”

Section: Discussionmentioning

confidence: 93%