Iron Status in Sickle Cell Anemia: Deficiency or Overload?

Area of Science:

• Hematology
• Genetics
• Internal Medicine

Background:

• Sickle cell anemia (SCA) is a hereditary blood disorder characterized by defective hemoglobin synthesis, leading to hemolytic anemia, pain crises, and organ damage.
• Iron store derangements are common in SCA due to various factors, and iron therapy is sometimes inappropriately prescribed.
• This study aimed to assess iron status and identify target organ damage in SCA patients.

Purpose of the Study:

• To evaluate the iron status in patients with sickle cell anemia.
• To correlate iron status with the presence and type of target organ damage.
• To inform appropriate treatment strategies regarding iron management in SCA.

Main Methods:

• A cross-sectional study involving 180 adult SCA patients at a tertiary care center in Western India.
• Iron status was determined using hemoglobin levels, serum iron, serum ferritin, and total iron-binding capacity (TIBC).
• Patients were classified as iron sufficient, deficient, or overloaded based on established reference ranges.

Main Results:

• The most affected age group was 21-30 years, with a male predominance.
• Joint pain and pallor were common symptoms/signs, and most patients reported a history of pain crises.
• Hepatopathy was the most frequent complication among patients with organ damage, although most patients had no complications.

Conclusions:

• While most SCA patients were iron sufficient, a significant proportion exhibited iron deficiency or overload, underscoring the need for iron status evaluation before treatment.
• Routine screening for end-organ damage is essential for all SCA patients, even if asymptomatic.