Identifying Early Iron Deficiency Anaemia in Sickle Cell Disease: Lessons Learnt from Newborn Sickle Cell Cohort in Tribal District, India

Abstract

Iron deficiency anaemia (IDA) is unusual in sickle cell disease (SCD). However, excessive urinary iron loss and mucosal/submucosal infarcts may result in poor absorption of iron in SCD. During the first decade of the disease, environmental factors and poor nutrition may also affect iron metabolism and contribute to iron deficiency in SCD. The present study assessed iron status and haematological profile of young children with SCD using serum Iron, Ferritin and Total Iron Binding Capacity (TIBC) to establish early diagnosis of IDA.Results showed that out of 6276 newborns screened, 33(0.52%) were detected to have SCD. Amongst 33,14(14.28%) children were suspected to have IDA. Iron studies revealed 42.4% of coexistent IDA with low serum Iron among 3 children, whereas high normal or raised TIBC was seen in 14 children. The findings emphasize that raised TIBC with normal serum iron may indicate early onset of IDA in the early decade of SCD, highlighting the need of timely initiation of iron therapy to prevent further severe events.