A Study of Serum Ferritin, Serum Iron and Total Iron Binding Capacity in Sickle Cell Disease

Dr. V.N. Mishra; Dr. N.K. Tirkey; Dr. Tulendra Singh Thakur

Volume : V, Issue : XI, November - 2015

A Study of Serum Ferritin, Serum Iron and Total Iron Binding Capacity in Sickle Cell Disease

Dr. V. N. Mishra, Dr. N. K. Tirkey, Dr. Tulendra Singh Thakur

Abstract :

Background : Sickle cell disease (SCD) patients can have iron deficiency or transfusional iron overload. It is important to know the pattern of iron parameters in different clinical states of SCD to decide when these patients require iron supplementation, blood transfusion or chelation therapy. Materials & Methods : From 2009 to 2010, 60 patients with sickle cell disease and 40 patients with sickle cell trait who fulfilled inclusion criteria were included in the study. 50 age matched healthy controls were selected. History, general and systemic examination was recorded according to proforma. Serum iron, ferritin and TIBC and required routine investigations were done. Chi square test was used for statistical analysis. Results : Out of 100 patients 60 were Sickle Cell Disease (35 males : 25 females) and 40 patients were Sickle Cell Trait (15 males : 25 females). 60% sickle cell disease patients had increased serum ferritin level, 36.6% had normal and 3.3% had decreased serum ferritin level. Serum iron level was normal in 58.3%, increased in 16.6% and decreased in 25% patients of sickle cell disease. Inadequate body iron store state was more frequently noted in non transfused sickle cell disease/trait patients as compared to the transfused (low serum ferritin 25.2% vs 2.2%). 75% of patients of sickle cell disease and sickle cell trait who received blood transfusion and 16% patients who did not receive blood transfusion were found to have increased serum ferritin with p value of < 0.0001. 73.6% patients of sickle cell disease were having raised serum ferritin during crisis with p value < 0.0028. Mean haemoglobin was lower in patients with sickle cell disease than in sickle cell trait (p value = 0.0018). None had features of end organ damage due to iron toxicity. Conclusion : Adult SCD patients in steady state versus vaso–occlusive crisis (VOC) have significantly different iron status vis a vis serum iron, ferritin and TIBC. Correct interpretation of serum iron, ferritin and TIBC is difficult in the setting of sickle cell anemia as they are modified by the chronic inflammatory state and chronic haemolytic/ hyperhaemolytic process of SCD.