Iron stores in adults with sickle cell anemia

• Published in: The Journal of laboratory and clinical medicine Vol. 103; no. 5; p. 792
• Main Authors: Rao, K R, Patel, A R, McGinnis, P, Patel, M K
• Format: Journal Article
• Language: English
• Published: United States 01-05-1984
• Subjects: Adolescent; Adult; Anemia, Hypochromic - etiology; Anemia, Hypochromic - metabolism; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - metabolism; Blood Transfusion; Bone Marrow - metabolism; Female; Ferritins - blood; Follow-Up Studies; Hematologic Tests; Hemosiderin - analysis; Humans; Iron - metabolism; Male; Middle Aged; Statistics as Topic; Transferrin - blood
• ISSN: 0022-2143

Iron status was investigated in 60 adults with sickle cell anemia as determined by stainable iron in bone marrow aspirates, serum ferritin, serum iron, and the total iron-binding capacity. Seventeen patients (28%) were found to have absent bone marrow iron. There was an excellent inverse correlation between serum ferritin and the serum transferrin (p less than 0.001), and a significant positive correlation between serum ferritin and transferrin saturation (p less than 0.005), bone marrow iron (p less than (p less than 0.001), and history of prior blood transfusion (p = 0.005). Results of complete radiologic examination of the gastrointestinal tract and proctoscopy were negative in the 17 patients in the iron-deficient group. The high incidence of iron deficiency may be related to excessive urinary losses of iron. Our data indicate that serum ferritin values of less than 30 ng/ml are diagnostic of iron deficiency in patients with sickle cell anemia, with a high degree of specificity (98.7%). However the sensitivity of the test at a serum ferritin level of 30 ng/ml is only 32%. The diagnostic evaluation and the management of sickle cell anemia in iron-deficient patients needs to be better defined.