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The diagnosis of iron deficiency anemia in sickle cell disease.
Blood 1981; 58(5):963-8Blood

Abstract

We determined the prevalence and optimal methods for laboratory diagnosis of iron deficiency anemia in patients with sickle cell disease. Laboratory investigations of 38 nontransfused and 32 transfused patients included transferrin saturation, serum ferritin, mean corpuscular volume (MCV), and free erythrocyte protoporphyrin (FEP). Response to iron supplementation confirmed the diagnosis of iron deficiency anemia in 16% of the nontransfused patients. None of the transfused patients were iron deficient. All iron-deficient patients (mean age 2.4 yr) had a low MCV, serum ferritin less than 25 ng/ml, transferrin saturation less than 15%, and FEP less than 90 micrograms/dl RBC. Following therapy, all parameters improved and the hemoglobin concentration increased greater than 2 g/dl. A serum ferritin below 25 ng/ml was the most reliable screening test for iron deficiency. There were 13% false positive results with transferrin saturation, 3% with MCV, and 62% with FEP. FEP values correlated strongly with reticulocyte counts. The high FEP was in part due to protoporphyrin IX and not completely due to zinc protoporphyrin, which is elevated in iron deficiency. We conclude that iron deficiency anemia is a potential problem in young nontransfused sickle cell patients. Serum ferritin below 25 ng/ml and low MCV are the most useful screening tests.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

7296005

Citation

Vichinsky, E, et al. "The Diagnosis of Iron Deficiency Anemia in Sickle Cell Disease." Blood, vol. 58, no. 5, 1981, pp. 963-8.
Vichinsky E, Kleman K, Embury S, et al. The diagnosis of iron deficiency anemia in sickle cell disease. Blood. 1981;58(5):963-8.
Vichinsky, E., Kleman, K., Embury, S., & Lubin, B. (1981). The diagnosis of iron deficiency anemia in sickle cell disease. Blood, 58(5), pp. 963-8.
Vichinsky E, et al. The Diagnosis of Iron Deficiency Anemia in Sickle Cell Disease. Blood. 1981;58(5):963-8. PubMed PMID: 7296005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The diagnosis of iron deficiency anemia in sickle cell disease. AU - Vichinsky,E, AU - Kleman,K, AU - Embury,S, AU - Lubin,B, PY - 1981/11/1/pubmed PY - 1981/11/1/medline PY - 1981/11/1/entrez SP - 963 EP - 8 JF - Blood JO - Blood VL - 58 IS - 5 N2 - We determined the prevalence and optimal methods for laboratory diagnosis of iron deficiency anemia in patients with sickle cell disease. Laboratory investigations of 38 nontransfused and 32 transfused patients included transferrin saturation, serum ferritin, mean corpuscular volume (MCV), and free erythrocyte protoporphyrin (FEP). Response to iron supplementation confirmed the diagnosis of iron deficiency anemia in 16% of the nontransfused patients. None of the transfused patients were iron deficient. All iron-deficient patients (mean age 2.4 yr) had a low MCV, serum ferritin less than 25 ng/ml, transferrin saturation less than 15%, and FEP less than 90 micrograms/dl RBC. Following therapy, all parameters improved and the hemoglobin concentration increased greater than 2 g/dl. A serum ferritin below 25 ng/ml was the most reliable screening test for iron deficiency. There were 13% false positive results with transferrin saturation, 3% with MCV, and 62% with FEP. FEP values correlated strongly with reticulocyte counts. The high FEP was in part due to protoporphyrin IX and not completely due to zinc protoporphyrin, which is elevated in iron deficiency. We conclude that iron deficiency anemia is a potential problem in young nontransfused sickle cell patients. Serum ferritin below 25 ng/ml and low MCV are the most useful screening tests. SN - 0006-4971 UR - https://www.unboundmedicine.com/medline/citation/7296005/The_diagnosis_of_iron_deficiency_anemia_in_sickle_cell_disease_ L2 - http://www.bloodjournal.org/cgi/pmidlookup?view=long&pmid=7296005 DB - PRIME DP - Unbound Medicine ER -