Iron deficiency in sickle cell anaemia

Area of Science:

• Hematology
• Genetics
• Nutritional Science

Background:

• Sickle cell disease (SCD) is a genetic blood disorder.
• Microcytosis in SCD can be caused by thalassaemia or other factors.
• Accurate diagnosis is crucial for appropriate management.

Purpose of the Study:

• To investigate the prevalence of iron deficiency in patients with SCD.
• To determine the reliability of microcytosis as an indicator of thalassaemia interaction in SCD.
• To assess the impact of iron deficiency on red blood cell indices in SCD.

Main Methods:

• Studied 37 patients with SCD.
• Analyzed haematological findings, including MCV, MCH, and Hb electrophoresis.
• Assessed alpha:non-alpha globin chain ratios.
• Measured serum ferritin levels.
• Reviewed patient case histories for potential causes of iron loss.

Main Results:

• Twenty-four patients had homozygous Hb S with balanced globin chains.
• Thirteen patients showed features suggestive of thalassaemia interaction.
• Seven microcytic patients with balanced globin chains were found to be iron deficient.
• Five patients (3 with Hb SS, 2 with Hb S/beta thalassaemia) had low serum ferritin.
• Identified peptic ulceration, epistaxis, and multiple pregnancies as causes of iron loss.

Conclusions:

• Iron deficiency is a common finding in SCD and can cause microcytosis.
• Microcytosis alone is an unreliable indicator of thalassaemia interaction in SCD without further investigation.
• Iron deficiency should be excluded as a cause of microcytosis in SCD patients.