Iron deficiency in Sudanese children with sickle cell anaemia

ABSTRACT

Iron status was studied in 100 patients with homozygous sickle cell disease between 4 months and 16 years of age. All patients were prescribed folic acid for at least 1 month prior to the study but none was taking any other medication or had received a blood transfusion during the previous 3 months. Basic haematologic data [Hb, PCV, reticulocyte and red cell counts, MCV, MCH, MCHC and peripheral blood picture], serum iron, total iron binding capacity [TIBC] and transferrin saturation were obtained in all 100 patients. Bone marrow aspiration and staining for iron was performed in 82 patients [over 2 years of age] and these were divided into three groups according to the results of marrow iron. There were 68 [83%] patients with absent marrow iron in group 1, five [6%] with reduced iron in group 2 and nine [11%] with sufficient marrow iron in group 3. In 18 patients [under 2 years of age] bone marrow aspiration Was not performed and these patients are referred to as group 4.Patients in group 1 had the lowest mean Hb and their basic haematologic data, serum iron, TIBC and transferrin saturation were compatible with the diagnosis of iron deficiency anaemia. Patients in group 2 showed evidence of early iron deficiency as indicated by reduction in marrow iron but there was no evidence of iron deficiency in other results. Group 3 patients showed no evidence of iron deficiency. Group 4 patients had basic haematologic data, serum iron, TIBC and transferring saturation similar to those in group 1. Although marrow iron content was not known for patients in group 4 available data were suggestive of iron deficiency anaemia in this group. Combining the results of groups 1 and 4, made the diagnosis of iron deficiency anaemia as high 35 86% in this study