title: Iron stores in adults with sickle cell anemia.
abstract: Iron status was investigated in 60 adults with sickle cell anemia as determined by stainable iron in bone marrow aspirates, serum ferritin, serum iron, and the total iron-binding capacity. Seventeen patients (28%) were found to have absent bone marrow iron. There was an excellent inverse correlation between serum ferritin and the serum transferrin (p less than 0.001), and a significant positive correlation between serum ferritin and transferrin saturation (p less than 0.005), bone marrow iron (p less than (p less than 0.001), and history of prior blood transfusion (p = 0.005). Results of complete radiologic examination of the gastrointestinal tract and proctoscopy were negative in the 17 patients in the iron-deficient group. The high incidence of iron deficiency may be related to excessive urinary losses of iron. Our data indicate that serum ferritin values of less than 30 ng/ml are diagnostic of iron deficiency in patients with sickle cell anemia, with a high degree of specificity (98.7%). However the sensitivity of the test at a serum ferritin level of 30 ng/ml is only 32%. The diagnostic evaluation and the management of sickle cell anemia in iron-deficient patients needs to be better defined.
mesh_terms: D000293:Adolescent; D000328:Adult; D000747:Anemia, Hypochromic / Q000209:etiology / Q000378:metabolism*; D000755:Anemia, Sickle Cell / Q000150:complications / Q000378:metabolism*; D001803:Blood Transfusion; D001853:Bone Marrow / Q000378:metabolism*; D005260:Female; D005293:Ferritins / Q000097:blood; D005500:Follow-Up Studies; D006403:Hematologic Tests; D006485:Hemosiderin / Q000032:analysis; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D014168:Transferrin / Q000097:blood
chemical_list: D014168:Transferrin; D005293:Ferritins; D006485:Hemosiderin; D007501:Iron