Iron deficiency in Brazilian infants with sickle cell disease

• Published in: Jornal de pediatria Vol. 87; no. 5; pp. 405 - 411
• Main Authors: Rodrigues, Priscila C, Norton, Rocksane C, Murao, Mitiko, Januario, José N, Viana, Marcos B
• Format: Journal Article
• Language: English
• Published: Brazil 01.09.2011
• Subjects: Anemia, Iron-Deficiency - epidemiology; Anemia, Iron-Deficiency - pathology; Anemia, Iron-Deficiency - prevention & control; Anemia, Sickle Cell - blood; Anemia, Sickle Cell - classification; Anemia, Sickle Cell - epidemiology; Biomarkers - blood; Blood Transfusion - statistics & numerical data; Brazil - epidemiology; Child, Preschool; Epidemiologic Methods; Female; Ferritins - blood; Humans; Infant; Male; Transferrin - analysis; Brazil
• ISSN: 0021-7557; 1678-4782
• DOI: 10.2223/JPED.2116

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sickle cell disease, mainly those with SC hemoglobin, may receive prophylactic iron; however, supplementation should be withdrawn after the first blood transfusion.