IRON STATUS IN MULTIPLY TRANSFUSED ADULT SICKLE CELL ANAEMIA PATIENTS, AT THE UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY

Abstract

Background:
Sickle cell anaemia (SCA) is a chronic haemolytic condition often requiring
frequent blood transfusions. The end result is that some patients with SCA are
prone to transfusion induced iron overload. Assessment of iron status
especially in the multi- transfused patients may help in ascertaining some of
the complications of SCA arising from chronic transfusion.
Aim:
This study was aimed at assessing serum iron, serum ferritin, total iron binding
capacity and percentage transferrin saturation and liver function tests. How
the iron parameters relate with the number of unit of blood transfused.
Subject and method:
The study population includes a total of eighty-six subjects comprising of sixty
adult sickle cell anaemia patients and twenty-six healthy HbAA control
subjects. The sickle cell anaemia subjects were further divided into 2
subgroups on the basis of the number of units of blood transfused. Full blood
counts were measured by automated cell counter. The liver function tests
were assayed by a spectrophotometer. The serum ferritin concentration was
assayed using ELISA method. Serum iron and total iron binding capacity were
assayed using a spectrophotometer and percentage transferrin saturation was

determined by calculating the ratio of serum iron to total iron binding capacity
expressed in percentage. Results were analysed using statistical package for
social science (SPSS) version 16; student t-test was used to compare means
and pearson’s correlation coefficient for associations between variables.
Probability values of less than or equal to 0.05 was taken as significant.
Result:
There was a significantly higher serum iron concentration (152.8±23.4µg/dl),
serum ferritin concentration(396.4±130.8µg/dl), percentage transferrin
saturation (55.2±99%) in the MT compare with the RT and CT subjects
(p=0.001).The number of units of blood correlated strongly with serum ferritin
concentration(r=0.719, p=000) and percentage transferrin saturation (r=0.407,
p=0.026).There was a significantly higher total bilirubin, alanine amino
transferase and aspartate amino transferase (p=0.001) in MT and RT compared
to the CT.
This study has shown that, there is a significant increase in serum iron, serum
ferritin and percentage transferrin saturation in the sickle cell anaemia patients
who had multiple transfusions.This Suggests an increase in iron stores and a
risk of developing iron overload. Hyperbilirubinaemia and a slight elevation in
liver enzymes which could suggest subclinical liver pathology in SCA regardless
of blood requirement.

IRON STATUS IN MULTIPLY TRANSFUSED ADULT SICKLE CELL ANAEMIA PATIENTS, AT THE UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY