Iron overload in steady state, non-chronically transfused children with sickle cell anaemia in Ile-Ife, Nigeria

Abstract

IntroductionThe estimation of serum ferritin level is a method of determining iron status. We studied the iron status of a group of non-chronically transfused children with sickle cell anaemia (SCA), using their serum ferritin levels. ObjectiveTo determine the iron status among children with SCA in steady state in Ile-Ife, Nigeria. Material and methodsThe study was carried out at the Consultant Paediatric Haematology Outpatient Clinic of the Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife between June and September 2013. History and clinical examination were evaluated in 48 HbSS subjects and 48 HbAA controls to ascertain that they did not have features of acute illness. Serum ferritin levels were assayed in both subjects and controls. Results/DiscussionThe age range of both subjects and controls was 1–15 years. The mean age was 8.0 (4.0) for both groups. The serum ferritin levels ranged from 34.2 to 3282.9 μg/l with mean of 381.2 (1.0), median 180 μg/l; this was significantly higher than that for the controls, with range of 3.7–26.6 μg/l, mean 46.1 (0.9) and median of 33.9 μg/l (p = 0.000). Among the SCA group 31 (64.6%) had had blood transfusion while 17 (35.4%) had not. The mean of the serum ferritin levels was not significantly higher in the group with blood transfusion compared with the group without blood transfusion (p = 0.923). Serum ferritin level was greater than 300 μg/l in 16 (33.3%) subjects with SCA, 6 (37.5%) of whom had no history of blood transfusion. There was no significant correlation between serum ferritin levels and age, haemoglobin concentration and number of blood transfusions. ConclusionDespite not being on chronic blood transfusion programme, higher serum ferritin levels indicative of iron overload were found in the SCA group compared with the controls. This suggests a tendency to excessive accumulation of iron within the reticuloendothelial tissues of the SCA group.