title: Iron deficiency in Brazilian infants with sickle cell disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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sickle cell disease, mainly those with SC hemoglobin, may receive prophylactic iron; however, supplementation should be withdrawn after the first blood transfusion.
authors.affiliation: Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG. Médica, Fundação Hemominas, Belo Horizonte, MG. Brazil. <vianamb@gmail.com>
authors.forename: Priscila C
authors.initials: PC
authors.lastname: Rodrigues
authors.forename: Rocksane C
authors.initials: RC
authors.lastname: Norton
authors.forename: Mitiko
authors.initials: M
authors.lastname: Murao
authors.forename: José N
authors.initials: JN
authors.lastname: Januario
authors.forename: Marcos B
authors.initials: MB
authors.lastname: Viana
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control; D000755:Anemia, Sickle Cell / Q000097:blood / Q000145:classification / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007223:Infant; D008297:Male; D014168:Transferrin / Q000032:analysis
chemical_list: D015415:Biomarkers; D014168:Transferrin; D005293:Ferritins