Differentiation of hypochromic anaemia in children by determination of free erythrocyte protoporphyrin, serum ferritin and fetal haemoglobin

ABSTRACT

In 86 children suffering from hypochromic anaemia of different causes, as iron deficiency [25], hereditary blood diseases [38]. Malignant blood diseases [14], and other diseases including collagen diseases [5], complicated hypoplastic anaemia [2], and chronic bilharziasis [2], and also in 20-age-and sex matched normal children, a study was conducted to evaluate whether free erythrocyte protoporphyrin [FEP], Serum ferritin [SF], and fetal haemoglobin [HbF] may help in the differentiation between the different causes of hypochromic anaemia, especially in those pale children who stand clinically on he border line and have vague histories. The results revealed that SF appeared at various levels, it was lower than normal in iron efficient and was very high in hereditary blood diseases, and other chronic disorders the level of SF varies from high normal to higher than normal. The FEP was found to be very high in iron deficient, was normal or high in hereditary blood diseases, and was high in other groups. The HbF was found to be normal in iron deficient, high in thalassaemia and sickle cell thalassaemia, but normal in sickle cell disease; it showed mild increase in malignant blood disease, and was normal in other groups. The FEP/Hb ratio was found to be of diagnostic help only in early detection of latent iron deficiency anaemia