Role of Lactoferrin in Chronic Telgon Effluvium

Abstract

Abstract Background Telogen effluvium (TE) is a widely prevalent hair condition and the second most common cause of hair loss after androgenetic alopecia. It presents as a nonpatterned increase in shedding of terminal hairs, diffusely over the entire scalp that can produce an apparent thinning of hair in severe cases. Both genders can experience telgon effluvium but females are the greater proportion of those who complain. Acute telgon effluvium is a form of non scarring alopecia with sudden conversion of large numbers of actively growing anagen to telogen hair leading to diffuse hair shedding. It is usually seen after severe illness, surgery, nutritional deficiency specially iron deficiency, postpartum, thyroid disease and in association with medications such as retionids, captopril and propranolol. It is reversible once the initiating factor is eliminated. Chronic TE (CTE) is a primary or idiopathic generalized telogen hair shedding from the scalp lasting more than 6 months without any apparent cause. It is characterized by insidious onset and fluctuating course. On examination, the hair appears normal in thickness with shorter re-growing hairs in the frontal and a bitemporal area, the hair pull test is commonly positive. Objectives The aim of this work was to assess the correlation between serum iron, ferritin and lactoferrin in chronic telgon effluvium with different clinical severities further supporting the notion for iron and lactoferrin supplementation in treatment of chronic telgon effluvium. Patients and Methods This study included 48 randomly selected patients suffering from chronic telogen effluvium attending outpatient clinics of Cairo hospital for dermatology and venerology (Al Haud Al Marsoud) and 40 control subjects, both cases and controls were age & sex matched. Laboratory assessment of CBC, serum iron, serum ferritin and lactoferrin in both cases and control groups. Results This study comprised of 48 patients with chronic telogen effluvium and 40 control subjects. Patients aged from 19-37 years old (mean 23.4 ± 5.4). 6 patients (12.5%) were males and 42 patients (87.5%) were females. The 40 control subjects involved in our study; aged from 20-36 years (mean 27.6 ± 5.4). 62.5% of patients had positive family history of similar condition; mean duration of disease was 25.4±14.9 months while associated androgenetic alopecia (diagnosed by trichoscopy) was seen in 56.3% of patients. Regarding severity, mean hair shedding visual scale was 4.38±1.47, while mean manual daily counting was 257.94±149.4. Conclusion Serum ferritin and lactoferrin were significantly lower in chronic telogen effluvium patients compared to controls while no significant difference in hemoglobin and serum iron was recorded.