Red cell ferritin and iron overload in heterozygous beta‐thalassemia

Abstract

Red cell ferritin was evaluated in 101 individuals with heterozygous beta-thalassemia to determine its clinical utility as an index for iron deficiency or overload in these subjects. The mean red cell ferritin for the total population was elevated threefold and showed a significant correlation with transferrin saturation, plasma ferritin, and HbA2 levels. Five of six subjects with reduced red cell ferritin had associated iron deficiency; a further five had iron deficiency and normal red cell ferritin. Normal red cell ferritin occurred in 51 subjects, and 44 had increased values. In the elevated red cell ferritin group, 21 individuals had associated normal plasma ferritin, and 23 had increased plasma ferritin. Only in the latter group was red cell ferritin significantly correlated with transferrin saturation and plasma ferritin. Ten individuals had a red cell ferritin greater than or equal to 150 attogram/cell, and liver biopsy performed in four showed grades II to IV iron overload. A clinical feature of subjects with both increased red cell and plasma ferritin levels was a high incidence of inappropriate iron administration. These findings suggest that red cell ferritin, particularly when combined with plasma ferritin, is a useful parameter for determining potential iron overload in individuals with heterozygous beta-thalassemia.

Erythrocyte Ferritin in Patients with Chronic Renal Failure and Heterozygous Beta-Thalassemia

“…Other researchers suggest that a proportion of subjects with heterozygous β-TA present iron overload because of a coexistence of idiopathic hemochromatosis [13]or because of an uncontrollable administration of iron [9]. Others also showed an increase in iron stores and inexplicable iron overload.…”

“…In thalassemic syndromes, EF is increased, and in heterozygous β-TA it shows a large variation [7, 8, 9]. We studied the variation of EF in patients with CRF and heterozygous β-TA; in addition, we compared EF with bone marrow iron in 11 patients with CRF and heterozygous β-TA.…”

EVALUATION OF SERUM FERRITIN AND SERUM IRON IN FREE-RANGING BLACK RHINOCEROS (DICEROS BICORNIS) AS A TOOL TO UNDERSTAND FACTORS AFFECTING IRON-OVERLOAD DISORDER

“…There may also be advantages of red cell ferritin over the assay of serum ferritin to estimate iron stores in patients with liver damage because the red cell ferritin concentration should not be greatly influenced by the release of ferritin from damaged liver cells. However, a high concentration of red cell ferritin is also found in individuals with thalassaemia (111,112), megaloblastic anaemia (113) or myelodysplastic syndromes (108) presumably indicating a disturbance of erythroid iron metabolism in these conditions. Despite these specific diagnostic advantages (114) an assay for red cell ferritin has seen little routine application.…”

Hereditary Red Blood Cell Disorders in Middle Eastern Patients

“…Numerous cases have been reported of patients who were prescribed long-term iron supplementation for presumed iron deficiency who instead had thalassemia; a few of these patients have developed complications of iron overload, including liver failure and diabetes. 56 Patients with thalassemia trait have also been subject to unnecessary endoscopic evaluations in search of a gastrointestinal bleeding source. The use of various "discriminant functions" based on RBC indices may help exclude iron deficiency, 57 but specificity and sensitivity are low.…”