ESTIMATION OF SERUM FERRITIN LEVEL OF A COHORT OF PATIENTS WITH SICKLE CELL ANEMIA IN PORT HARCOURT, NIGERIA
Abstract
Background: Iron overload remains a significant clinical concern in sickle cell anemia (SCA) despite contrary reports of adequate iron stores and overt iron deficiency anemia in SCA. It has therefore, become imperative to evaluate the iron status of sickle cell patients in Rivers state –Nigeria.
Methodology: This was a Prospective Study of 108 subjects comprising of 54 SCA patients and 54 aged, sex matched normal (HbAA) control. Serum ferritin was determined by spectrophotometric method.
Result: The SCA patients had a mean serum ferritin level of 300±200 µg/L (range; 80 to 1,200 µg/L) which was higher than the mean of 88±22 µg/L (range 12-150µg) of the control group (P < 0.001). There was a weak direct correlation between serum ferritin concentration and the number of units of blood transfused (r = 0.25 (P = 0.061). Forty three (80%) of the SCA patients had increased iron stores while eleven (20%) had adequate iron stores comparable to the healthy control group. There was no serum ferritin level suggestive of iron deficiency anemia from this study.
Conclusion: We therefore recommend sequential iron studies for patients on recurrent blood transfusion, while iron supplementation should only be given in established cases of iron deficiency anemia .
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References
2. Wood KC, Hsu LL, Gladwin MT (2008). Sickle cell disease vasculopathy: A state of nitric oxide resistance. Free radical biology and medicine 44:1506–28.
3. Lee MT, Piomelli S, Granger S, Miller, S T, Harkness s, Donald J. Brambilla, D. J, Robert J. Adams, R. J (2006). Stroke Prevention Trial in Sickle Cell Anemia
(STOP): extended follow-up and final results. Blood 108:847–52.
4. Malouf AJ Jr, Hamrick-Turner JE, Doherty MC, Dhillon GS, Iyer R V, Smith MG, (2001). Implementation of the STOP protocol for Stroke Prevention in Sickle Cell Anemia by using duplex power Doppler imaging. Radiology 219: 359–65.
5. Darbari DS, Kple-Faget P, KwagyanJ, Rana S, Gordeuk VR, Castro O (2006). Circumstances of death in adult sickle cell disease patients. American Journal of
Hematology 81(11):858-863.
6. Oluboyede OA, Usang EA, Lukanbi FA, Ajayi OA.(1983). Evaluation of serum ferritin levels and other hematological parameters in a Nigerian population. Journal of the National Medical Association 75:885–889.
7. Elliot Vinchinsky, Klara Kleman, Steven Embury, and Bertram Lubin.(1981). Diagnosis of Iron Deficiency Anemia in Sickle cell Disease. Blood Vol.58: 5.
8. Davies S, Henthrorn J, Brozovic M.(1983). Iron deficiency in sickle cell anemia. Journal of Clinical Pathology 36:1012–1015.
9. Mohanty D, Mukherjee MB, Colah R B, Ghosh M et al.(2008). Iron deficiency anaemia in Sickle cell disorders in India. Indian journal of medical research 127:366-369.
10. Aken’ova YA, Adeyefa I, Okunade M. (1997). Ferritin and serum iron levels in adults patients with sickle cell anaemia at Ibadan, Nigeria. African Journal of Medicine and Medical Sciences 26:39-41.
11. Olaniyi JA, Akinlade KS, Atere AD and Arinola OG.(2014). Serum Iron Status and Haematological Profiles in Adult Nigerian Sickle Cell Anaemia Patients International Journal of Tropical Disease and Health 4(8): 917-927.
12. Ikusemoro I,Halim NKD, Awodu OA, Ehiaghe FA, et al.(2014). Iron Status of Multiple Transfused Sickle Cell Anaemia Patients Attending a Sickle cell clinic in
Benin City Nigeria. Open journal of pathology 4:25-31.
13. Fung EB, Harmatz P, Milet M, et al. (2007). Morbidity and mortality in chronically transfused subjects with thalassemia and sickle cell disease: A report from the multi-center study of iron overload American Journal of Hematology 82(4):255-265.
14. Inati A, Musallam KM, Wood JC, Taher AT.(2010). Iron overload indices rise linearly with transfusion rate in patients with sickle cell disease. Blood 115(14): 2980-2981.
15. Yutaka Kohgo, Katsuya Ikuta,Takaaki Ohtake, Yoshihiro Torimoto, Junji Kato.(2008).Body iron metabolism and pathophysiology of iron: International Journal of Hematology 88(1): 7–15.
16. Gattermann N. (2007).Guidelines on iron chelation therapy in patients with Myelodysplastic syndromes and transfusional iron overload. Leukemia research 31(3):S10-5.
