Serum ferritin, serum nitric oxide, and cognitive function in pediatric thalassemia major

Abstract

Background Hemolysis and repeated blood transfusions in children with thalassemia major cause iron overload in various organs, including the brain, and may lead to neurodegeneration. Hemolysis also causes decreased levels of nitric oxide, which serves as a volume transmitter and slow dynamic modulation, leading to cognitive impairment. Objective To assess for correlations between serum ferritin as well as nitric oxide levels and cognitive function in children with thalassemia major. Methods This analytical study with cross-sectional design on 40 hemosiderotic thalassemia major patients aged 6-14 years, was done at the Thalassemia Clinic in Dr. Hasan Sadikin Hospital, Bandung, West Java, from May to June 2015. Serum ferritin measurements were performed by an electrochemiluminescence immunoassay; serum nitric oxide was assayed by a colorimetric procedure based on Griess reaction; and cognitive function was assessed by the Wechsler Intelligence Scale for Children test. Statistical analysis was done using Spearman's Rank correlation, with a significance value of 0.05. Results Abnormal values in verbal, performance, and full scale IQ were found in 35%, 57.5% and 57.5%, respectively. Serum nitric oxide level was significantly correlated with performance IQ (P=0.022), but not with verbal IQ (P=0.359) or full scale IQ (P=0.164). There were also no significant correlations between serum ferritin level and full scale, verbal, or performance IQ (P=0.377, 0.460, and 0.822, respectively

Psychological Burden among Pediatric Thalassemia Major Patients in Indonesia: A Review

“…Interestingly, another study [51] revealed that the IQ score was not correlated with the ferritin serum level. Still, it was correlated with the mean pre-transfusion Hb level, education, and nutritional status [51].…”

“…In terms of cognitive ability, a study [50] in children with β-thalassemia major showed that they had lower IQ scores than healthy children, as well as lower verbal comprehension index, processing speed index, perceptual reasoning index, and working memory index [50]. Interestingly, another study [51] revealed that the IQ score was not correlated with the ferritin serum level. Still, it was correlated with the mean pre-transfusion Hb level, education, and nutritional status [51].…”

Telenursing Using SKEDit To Educate Parents with Thalassemia Children

“…An evaluation of thalassemia interventions needs to be conducted as based on the research by Qurbani, Reniarti, Chairulfatah (2017), which studied approximately 40 hemosiderotic thalassemia major patients aged between 6-14 years at the Thalassemia Clinic in Dr. Hasan Sadikin Hospital, Bandung and it showed that 73% had an average Hb level of less than 7,2 g/dl and an average/median serum ferritin level of 3.687 ng/ml before transfusion. This condition i.e.…”