Screening of Iron Status among Egyptian Children with Sickle Cell Disease : A Single Center Study

Amina Abdel-Salam; Fadwa Said

doi:10.12816/0014272

Article Details

Screening of Iron Status among Egyptian Children with Sickle Cell Disease : A Single Center Study

Authors:

Amina Abdel-Salam | Fadwa Said

Publisher:

Union of Arab Pediatric Societies

Main Topics:

Medicine

Journal:

Journal of Arab Child 2013 Vol.24 Issue 3, pp.227-233

Document Type:

Article

Publication Date:

9/2013

Document Language:

English

Document ID (Org No.):

69586

Frequency:

Quarterly

pISSN:

11100672

DOI:

10.12816/0014272

Descriptors:

Keywords:

Abstract:

 Background: There is a potential risk of iron overload in children with sicklecell disease (SCD) secondary to red blood cell transfusions and increasedgastrointestinal absorption of iron. Nevertheless, SCD children may be at riskof iron deficiency due to increased intravascular hemolysis with subsequentincrease in urinary losses. Serum ferritin is the popular estimate of iron statusin steady-state sickle cell disease. 
Objective: In this study, we aimed todetermine the prevalence of iron overload and iron deficiency among Egyptainchildren with SCD in a steady state through estimating serum ferritin level andto determine predictors of iron overload among the studied cases. 
Materialsand Methods: We measured serum ferritin by a solid-phase, 2-sitechemiluminescent immunometric assay in 80 steady state children with sicklecell disease (42 males and 38 females) and 40 apparently healthy age/sexmatched controls. Results: Half of SCD children had serum ferritin within thereference range, 35% had elevated serum ferritin and were considered at highrisk of iron overload, 12.5% had definite iron overload and 2.5% had depletediron stores. Mean serum ferritin was significantly higher in SCD childrencompared to controls (p_0.001) and in regularly transfused SCD childrencompared to occasionally or infrequently transfused cases (p_0.001). Nosignificant difference in mean levels of serum ferritin was found in SCD malesand females (p_0.05) or in children of different age groups (p_0.05). We foundsignificant positive correlation between serum ferritin and transfusion rate (r=0.4, p _ 0.001), reticulocytic count (r =0.3, P = 0.01), and lactate dehydrogenaselevel (LDH) (r =0.3, p = 0.02). No correlations were detected between serumferritin level and age (p>0.05), hemoglobin level (p>0.05), frequency ofvasoocclusive crises (p>0.05) or frequency of hospital admissions (p>0.05).Multiple Logistic regression analysis proved that transfusion rate (TR) was thebest predictor of iron overload (OR 1.568; 95% CI: 1.189-2.066, p=0.001).
Conclusion: Normal iron status is common, iron overload and iron deficiency,are quite rare in Egyptian children with SCD. However, over one third ofchildren are at high risk of iron overload. In children with SCD, increasedserum ferritin is associated with increases in transfusion rate and hemolysis butnot related to VOC frequency. Periodic screening with serum ferritin isrecommended for all children with SCD, especially those who are regularlytransfused regardless their age and gender.

Article Details

Screening of Iron Status among Egyptian Children with Sickle Cell Disease : A Single Center Study

Authors:

Amina Abdel-Salam | Fadwa Said

Publisher:

Union of Arab Pediatric Societies

Main Topics:

Medicine

Journal:

Journal of Arab Child 2013 Vol.24 Issue 3, pp.227-233

Document Type:

Article

Publication Date:

9/2013

Document Language:

English

Document ID (Org No.):

69586

Frequency:

Quarterly

pISSN:

11100672

DOI:

10.12816/0014272

Descriptors:

SERUM FERRITIN

CHILDREN DISEASES

BLOOD DISEASES

IRON OVERLOAD

SERA

SERUM FERRITIN

IRON STATUS

SCREENING

SICKLE CELL DISEASE

CHILDREN

Issues

Article Details

Authors: Amina Abdel-Salam | Fadwa Said

Publisher: Union of Arab Pediatric Societies

Main Topics: Medicine

Journal: Journal of Arab Child 2013 Vol.24 Issue 3, pp.227-233

Document Type: Article

Publication Date: 9/2013

Document Language: English

Document ID (Org No.): 69586

Frequency: Quarterly

pISSN: 11100672

DOI: 10.12816/0014272

Descriptors:

Issues

Authors:

Amina Abdel-Salam | Fadwa Said

Publisher:

Union of Arab Pediatric Societies

Main Topics:

Medicine

Journal:

Journal of Arab Child 2013 Vol.24 Issue 3, pp.227-233

Document Type:

Article

Publication Date:

9/2013

Document Language:

English

Document ID (Org No.):

69586

Frequency:

Quarterly

pISSN:

11100672

DOI:

10.12816/0014272