Iron deficiency in Brazilian infants with sickle cell disease.

Priscila C Rodrigues, Rocksane C Norton, Mitiko Murao, José N Januario, Marcos B Viana

Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG. Médica, Fundação Hemominas, Belo Horizonte, MG. Brazil. <vianamb@gmail.com>

Jornal de pediatria 2011 Sep-Oct

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To assess iron deficiency or overload in infants with sickle cell disease in order to support the decision to recommend (or not) iron prophylactic supplementation in this population. Cross-sectional and retrospective study with 135 infants below 2 years old (66 boys and 69 girls), 77 with SS and 58 with SC hemoglobin, born between 2005 and 2006 in Minas Gerais, Brazil. Indicators of possible iron deficiency were: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), transferrin saturation (TS), and ferritin. Blood transfusions had been given to 17 infants (12.6%, 95% confidence interval [95%CI] 7.0-18.2%) before laboratory tests were done. Ferritin and TS were significantly lower in SC infants (p < 0.001). When two indices were considered for the definition of iron deficiency (low MCV or MCH plus low ferritin or TS), 17.8% of children (95%CI 11.3-24.3%) presented iron deficiency, mainly those with SC hemoglobin (p = 0.003). An analysis of infants who were not given transfusions (n = 118) showed that 19.5% presented iron deficiency. Fifteen infants (11.3%, 95%CI 5.9-16.7%) presented increased ferritin; the majority had been transfused. Most infants with sickle cell disease do not develop iron deficiency, though some have a significant deficit. This study indicates that infants with sickle cell disease, mainly those with SC hemoglobin, may receive prophylactic iron; however, supplementation should be withdrawn after the first blood transfusion.

Citation

Priscila C Rodrigues, Rocksane C Norton, Mitiko Murao, José N Januario, Marcos B Viana. Iron deficiency in Brazilian infants with sickle cell disease. Jornal de pediatria. 2011 Sep-Oct;87(5):405-11