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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
A Study of the Clinical Profile of Iron Deficiency Anemia in Children With Sickle Cell Disease in a Tertiary Care
Naramreddy Sudheesh Reddy1, Keta Vagha1, Ashish Varma1
1Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Insights
Iron deficiency anemia (IDA) affects 15% of children with sickle cell disease (SCD). Managing IDA in SCD requires tailored approaches to improve health outcomes and reduce complications in pediatric patients.
Area of Science:
- Pediatric Hematology
- Genetic Blood Disorders
- Nutritional Anemias
Background:
- Sickle cell disease (SCD) and iron deficiency anemia (IDA) are prevalent global health issues, especially in children.
- Co-occurrence of SCD and IDA presents diagnostic and management complexities.
- Understanding IDA's impact on pediatric SCD is crucial for effective care.
Purpose of the Study:
- To investigate the prevalence of IDA in children diagnosed with SCD.
- To analyze the clinical impact and management challenges of IDA in this population.
- To provide insights for refining clinical practices in managing co-existing SCD and IDA.
Main Methods:
- Prospective observational study involving 60 children with SCD.
- Comprehensive assessments including medical history, physical examination, and hematological tests.
- IDA diagnosis based on hemoglobin, MCV, RDW, serum iron, and ferritin levels.
Main Results:
- Iron deficiency was identified in 15% of the pediatric SCD cohort.
- Significant associations found between SCD type and pallor (p=0.025) and sickle cell crises (p=0.023).
- No significant association between SCD type and organomegaly (p=0.079) or iron deficiency (p=0.675).
Conclusions:
- Diagnosing and managing IDA in children with SCD is complex due to overlapping symptoms and transfusion-related iron overload risks.
- Tailored diagnostic and therapeutic strategies are essential for improving outcomes.
- A multidisciplinary approach is vital for managing these intertwined conditions and enhancing children's quality of life.
Abstract:
Background Sickle cell disease (SCD) and iron deficiency anemia (IDA) are significant global health concerns, particularly in pediatric populations. This study investigates the prevalence, clinical impact, and management challenges of IDA in children with SCD. Methods A prospective observational study was conducted at the Department of Pediatrics, Jawaharlal Nehru Medical College (JNMC) and Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, from June 2022 to May 2024. The study included 60 children diagnosed with SCD. Comprehensive assessments were performed, including medical histories, physical examinations, and hematological investigations. Diagnosis of IDA was based on hemoglobin levels, mean corpuscular volume (MCV), red cell distribution width (RDW), peripheral blood smears, serum iron levels, and serum ferritin concentrations. Results Of the 60 participants, 15% exhibited iron deficiency. No significant gender differences were found in iron deficiency status. A significant association was observed between SCD type and the presence of pallor (p = 0.025) and sickle cell crises (p = 0.023). The study also found no significant association between SCD type and the presence of organomegaly (p = 0.079) or iron deficiency status (p = 0.675). The mean hemoglobin levels varied across SCD types, with sickle cell anemia patients showing lower levels than those with sickle cell trait or disease. Conclusion Diagnosing and managing IDA in children with SCD is complex due to overlapping hematological features and the risk of iron overload from frequent transfusions. Tailored diagnostic and therapeutic approaches are essential to improving hemoglobin levels, reducing complications, and enhancing the quality of life for affected children. This study provides valuable insights for refining clinical practices and emphasizes the need for a multidisciplinary approach to managing these intertwined conditions.
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