Skip to main content
PMC home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1983 Sep;36(9):1012–1015. doi: 10.1136/jcp.36.9.1012

Iron deficiency in sickle cell anaemia.

S Davies, J Henthorn, M Brozović
PMCID: PMC498461  PMID: 6886017

Abstract

Thirty-seven patients with SCD were studied: 24 were diagnosed as homozygous Hb S on the basis of their haematological findings, and alpha:non-alpha globin chain ratios were found to be balanced in all. Thirteen patients were thought to have alpha or beta thalassaemia interaction with Hb S on the basis of low MCV and MCH, family history and/or presence of Hb A on electrophoresis. Six of them had abnormal alpha:non-alpha ratio (one had a ratio of 0.72 suggestive of alpha thalassaemia, and five had ratios between 1.4 and 1.9, compatible with beta thalassaemia interaction). The remaining seven patients with microcytosis had balanced globin chain synthesis and five were found to be iron deficient. Five additional patients (3 with Hb SS and 2 with Hb S/beta thalassaemia) had lower than normal serum ferritin concentration. The analysis of case histories disclosed that peptic ulceration, recurrent epistaxis and multiple pregnancies could account for iron loss in seven patients. These findings indicate that iron deficiency may be common in SCD and should be excluded as a cause of microcytosis. Microcytosis, in the absence of conclusive family studies and/or presence of Hb A on electrophoresis, is an unreliable indicator of alpha or beta thalassaemia interaction with Hb S.

Full text

PDF
1012

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Addison G. M., Beamish M. R., Hales C. N., Hodgkins M., Jacobs A., Llewellin P. An immunoradiometric assay for ferritin in the serum of normal subjects and patients with iron deficiency and iron overload. J Clin Pathol. 1972 Apr;25(4):326–329. doi: 10.1136/jcp.25.4.326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BETKE K., MARTI H. R., SCHLICHT I. Estimation of small percentages of foetal haemoglobin. Nature. 1959 Dec 12;184(Suppl 24):1877–1878. doi: 10.1038/1841877a0. [DOI] [PubMed] [Google Scholar]
  3. Clegg J. B., Naughton M. A., Weatherball D. J. Abnormal human haemoglobins. Separation and characterization of the alpha and beta chains by chromatography, and the determination of two new variants, hb Chesapeak and hb J (Bangkok). J Mol Biol. 1966 Aug;19(1):91–108. doi: 10.1016/s0022-2836(66)80052-9. [DOI] [PubMed] [Google Scholar]
  4. Embury S. H., Dozy A. M., Miller J., Davis J. R., Jr, Kleman K. M., Preisler H., Vichinsky E., Lande W. N., Lubin B. H., Kan Y. W. Concurrent sickle-cell anemia and alpha-thalassemia: effect on severity of anemia. N Engl J Med. 1982 Feb 4;306(5):270–274. doi: 10.1056/NEJM198202043060504. [DOI] [PubMed] [Google Scholar]
  5. Felice A. E., Webber B., Miller A., Mayson S. M., Harris H. F., Henson J. B., Gravely M. E., Huisman T. H. The association of sickle cell anemia with heterozygous and homozygous alpha-thalassemia-2: in vitro HB chain synthesis. Am J Hematol. 1979;6(2):91–106. doi: 10.1002/ajh.2830060202. [DOI] [PubMed] [Google Scholar]
  6. Higgs D. R., Aldridge B. E., Lamb J., Clegg J. B., Weatherall D. J., Hayes R. J., Grandison Y., Lowrie Y., Mason K. P., Serjeant B. E. The interaction of alpha-thalassemia and homozygous sickle-cell disease. N Engl J Med. 1982 Jun 17;306(24):1441–1446. doi: 10.1056/NEJM198206173062402. [DOI] [PubMed] [Google Scholar]
  7. Hussain M. A., Davis L. R., Laulicht M., Hoffbrand A. V. Value of serum ferritin estimation in sickle cell anaemia. Arch Dis Child. 1978 Apr;53(4):319–321. doi: 10.1136/adc.53.4.319. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Nagaraj Rao J., Sur A. M. Iron deficiency in sicle cell disease. Acta Paediatr Scand. 1980 May;69(3):337–340. doi: 10.1111/j.1651-2227.1980.tb07089.x. [DOI] [PubMed] [Google Scholar]
  9. O'Brien R. T. Iron burden in sickle cell anemia. J Pediatr. 1978 Apr;92(4):579–582. doi: 10.1016/s0022-3476(78)80291-1. [DOI] [PubMed] [Google Scholar]
  10. Peterson C. M., Graziano J. H., de Ciutiis A., Grady R. W., Cerami A., Worwood M., Jacobs A. Iron metabolism, sickle cell disease, and response to cyanate. Blood. 1975 Oct;46(4):583–590. [PubMed] [Google Scholar]
  11. Serjeant G. R., Serjeant B. E. A comparison of erythrocyte characteristics in sickle cell syndromes in Jamaica. Br J Haematol. 1972 Aug;23(2):205–213. doi: 10.1111/j.1365-2141.1972.tb03473.x. [DOI] [PubMed] [Google Scholar]
  12. Vichinsky E., Kleman K., Embury S., Lubin B. The diagnosis of iron deficiency anemia in sickle cell disease. Blood. 1981 Nov;58(5):963–968. [PubMed] [Google Scholar]
  13. Walford D. M., Deacon R. Globin chain biosynthesis in iron deficiency. Br J Haematol. 1980 Feb;44(2):201–209. doi: 10.1111/j.1365-2141.1980.tb01202.x. [DOI] [PubMed] [Google Scholar]
  14. Washington R., Boggs D. R. Urinary iron in patients with sickle cell anamia. J Lab Clin Med. 1975 Jul;86(1):17–23. [PubMed] [Google Scholar]
  15. YOUNG D. S., HICKS J. M. METHOD FOR THE AUTOMATIC DETERMINATION OF SERUM IRON. J Clin Pathol. 1965 Jan;18:98–102. doi: 10.1136/jcp.18.1.98. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES