A Study of Serum Ferritin Level in Female Patient with Alopecia

Abstract

Introduction: Total body iron store is an integral factor in the development of hair follicle. Numerous studies have been done seeking for the relationship between body iron store and various forms of chronic diffuse hair loss, with relatively contradictory findings in various reports in these studies. The main objective of this study is to find out if there is any association between total body iron store and various types of chronic diffuse hair loss in females in reproductive age. Materials and Methods: This is a hospital based case control study conducted in Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. Sixty female patients of age group 15-50 years with chronic diffuse hair loss with equal number of age-and sexmatched controls were studied. Both of the study groups were evaluated for various parameters of iron status. Results: The mean value of serum ferritin in cases was significantly lower as compared to controls (p=0.018). Patients with alopecia areata (p=0.008) and androgenetic alopecia (p=0.021) had significantly lower serum ferritin, whereas there was no statistically significant difference in telogen effluvium and controls (p=0.857).The mean value of hemoglobin, hematocrit and mean corpuscular hemoglobin was found to be significantly lower in alopecia areata and androgenetic alopecia. However, there was no statistically significant difference in RBC indices of patients of telogen effluvium and controls. Conclusion: Diffuse chronic hair loss shows definite association with serum ferritin and various RBC indices in female of reproductive age group. Alopecia areata and androgenetic alopecia show major association with total body iron stores.Keywords: alopecia areata; androgenetic alopecia; serum ferritin; telogen effluvium. 117 2017 to 28 February 2018. Written consent was taken from all the study subjects before their inclusion in the study. The study comprised of 120 female patient of reproductive age group (15-50 years) presenting to the dermatology department of Nobel Medical College and Teaching Hospital, Biratnagar, of which 60 were case and 60 controls. The diagnosis of various types of alopecia was made on the basis of history and clinical examination. Androgenetic alopecia, telogen effluvium and alopecia areata were included in the study. Inclusion criteria for cases: all the consenting female patients of age group 15-50 years with chronic hair loss. Exclusion criteria for cases: Participants on iron, folic acid, vitamin B12, pregnancy in the preceding one year, undergoing major surgery, endocrine abnormalities, on medication for systemic disorders and acute inflammatory condition. Inclusion criteria for controls: the control group comprised of age and sex matched patients presenting to the dermatology department for some other dermatological abnormality not directly related to alopecia of iron deficiency.Exclusion criteria for controls: Participants on iron, folic acid, vitamin B12, pregnancy in the preceding one year, undergoing major surgery, endocrine abnormalitie...

Investigate the role of Zinc and Ferritin in Iraqi patients with alopecia areata

“…Globally, in Nepal, 60 female patients of age group 15-50 years with chronic diffuse hair loss with equal number of age-and gender-matched controls were enrolled in hospital based case control study. Patients with AA and androgenetic alopecia had significantly lower serum ferritin than controls [14]. Also in accordance with current study there are two studies by Kantor et al [15] and Esfandiarpour et al [16] who also found mean serum ferritin level to be significantly lower in cases than in control.…”

Association of serum ferritin with chronic diffuse alopecia in female patient

“…A Nepali study reported mean Hb level in CTE was 10.01±1.33 g/dl. 18 In present study 92.9% females with diffuse hair loss showed lower serum ferritin level (SFL) (<30 ng/ml) with mean SFL 16.3±11.61 ng/ml. Tamer et al found mean SFL of females with chronic diffuse hair loss was 14.72±10.70 ng/ml.…”

“…A Nepali study found mean SFL in FPHL was 18.39±9.14 ng/ml. 18 A Bangladeshi study also found significantly lower mean SFL in FPHL with a mean SFL 12.50 ±3.37 ng/ml. 22 In this study, females with chronic diffuse hair loss, 34.3% subjects were in iron deficiency state (SFL<12ng/ml), 34.3% were in iron depletion state (SFL 12-20 ng/ml) and only 2.9% had normal ferritin level (SFL >70 ng/ml).An Indian study found 65% of the subjects were in iron deficient state and 20% of the subjects were in iron depleted state .…”

Iron Deficiency and Nonscarring Alopecia in Women: Systematic Review and Meta-Analysis

“…When the studies were pooled, a statistically significant difference was seen, with the mean ferritin values lower in patients with alopecia at MD = −18.51 ng/dL (−25.85; −11.16; p < 0.01) with significant heterogeneity among the studies (I 2 = 93%, p < 0.01). When outliers [19,29,33] were excluded from the meta-analysis, a statistically significant difference in ferritin levels was still seen between the patients and controls at MD = −18.23 ng/dL (−22.93; −13.53; p < 0.01, I 2 = 74%, p < 0.01). When the studies were omitted one at a time in the influence analyses, the difference in pooled MD between patients and controls was still statistically significant.…”

“…When the studies were pooled in the meta-analysis, a statistically significant difference was seen with lower mean ferritin levels in patients with alopecia (MD = −20.65 ng/dL [−29.74; −11.55; p < 0.01]) with significant heterogeneity among the studies (I 2 = 94%, p < 0.01). A statistically significant difference in ferritin levels between the patients and controls was still found when outlier papers [19,29,33] were omitted from the meta-analysis (MD = −21.11 ng/dL [−28.14; −14.08; p < 0.01, I 2 = 80%, p < 0.01]). Omitting study by study in influence analyses still resulted in a statistically significant difference in pooled MD between patients and controls.…”