[Iron status in 72 Congolese patients with sickle cell anemia]

Area of Science:

• Hematology
• Pediatric Medicine
• Nutritional Science

Background:

• Iron status in African children is influenced by multiple blood transfusions, parasitic infections, and growth-related iron demands.
• Sickle cell disease (SCD) presents unique challenges to maintaining iron homeostasis, particularly in resource-limited settings.

Purpose of the Study:

• To assess iron status in children with homozygous sickle cell disease (HbSS) in Kinshasa.
• To investigate the association between iron status and factors like blood transfusions and parasitic infections in this cohort.
• To compare iron status markers between SCD patients and a healthy control group.

Main Methods:

• A cohort of 72 homozygous sickle cell patients in steady state was studied in Kinshasa.
• Iron status was evaluated using multiple biomarkers: ferritin, transferrin, complete blood count, total iron-binding capacity, transferrin saturation, and C-reactive protein.
• Results were compared against a matched control group without sickle cell disease.

Main Results:

• Compared to controls, 5 (11%) sickle cell patients exhibited iron deficiency.
• A significant proportion, 18 (35%) of patients, presented with iron overload, likely linked to multiple blood transfusions.
• Iron status indicators revealed a higher prevalence of both deficiency and overload in the SCD group.

Conclusions:

• Homozygous sickle cell patients in Kinshasa experience significant iron imbalances, including both deficiency and overload.
• Multiple blood transfusions are a probable cause of iron overload in this population.
• Periodic monitoring of iron status is crucial for preventing and managing iron imbalances in sickle cell patients.