Iron deficiency in Brazilian infants with sickle cell disease

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sickle cell disease,mainly those with sc hemoglobin,may receive prophylactic iron; however,supplementation should be withdrawn after the first blood transfusion. copyright © 2011 by sociedade brasileira de pediatria.