ISSN 2997-1036
International Journal of Hematology | Vol. 7, No. 9, September 2016 | pp. 65–72
DOI: 10.46882/2016/IJH/000081
Original Article
Title: Serum ferritin kinetics and subclinical organ dysfunction in non-transfused adult sickle cell anemia patients
Names of Authors: A. I. Ibrahim¹, C. D. Balogun², E. O. Ojo³
Authors’ Affiliations: ¹Department of Haematology, Ahmadu Bello University, Zaria, Nigeria; ²Department of Medicine, University of Ilorin, Ilorin, Nigeria; ³Department of Chemical Pathology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
Abstract: Iron overload is widely studied in transfusion-dependent hemoglobinopathies, but hyperferritinemia and tissue iron deposit kinetics in non-transfused or minimally transfused sickle cell anemia cohorts remain poorly characterized. This cross-sectional study evaluated steady-state serum ferritin levels, transferrin saturation, and biochemical markers of hepatic and renal function in 94 adult sickle cell anemia (HbSS) patients who had received fewer than three lifetime blood transfusions. Steady-state serum ferritin was measured via an enzyme-linked immunosorbent assay. Hyperferritinemia (ferritin > 300 ng/ml in males, > 200 ng/ml in females) was detected in 31.9% (30 of 94) of the non-transfused patients, despite normal or low transferrin saturation profiles (< 30.0%). Elevated serum ferritin levels correlated positively with serum lactate dehydrogenase (r = 0.58, P < 0.001) and alanine aminotransferase activity, reflecting a state of chronic intravascular hemolysis and ongoing chronic inflammation rather than true parenchymal iron accumulation. Patients within the highest ferritin quartile demonstrated significantly higher microalbuminuria rates. These findings indicate that elevated ferritin in non-transfused sickle cell cohorts serves as an acute-phase reactant driven by chronic hemolytic endothelial stress, functioning as an adjunctive biomarker for subclinical microvascular target-organ damage.
Keywords: Sickle cell anemia, serum ferritin, chronic hemolysis, microalbuminuria, hyperferritinemia
Manuscript Timeline: Received: June 15, 2016; Revised: July 28, 2016; Accepted: August 14, 2016; Published: September 15, 2016