Concomitant Iron Deficiency with B-Thalassaemia Minor in Preschool Children in Erbil City

Authors

  • Qutaiba Raad Hamoodi Department of Pediatrics, Raparin Teaching Hospital, Erbil
  • Morouge Hashem Al-Ani Department of Pediatrics, Professor at College of Medicine, HMU, Erbil

DOI:

https://doi.org/10.56056/amj.2018.57

Keywords:

Iron deficiency anaemia, Hemoglobin A2, ? thalassemia minor;

Abstract

Background and objectives: Iron deficiency anaemia and beta thalassaemia trait are the most common microcytichypochromic anaemias, however, coincidence of both has been the topic of few studies. This study carried out to determine if iron deficiency coexists and to which extent, also influence on hemoglobinA2 level and link to demographical and biochemical parameters among ?-thalassemia trait children aged 1 to 5. 

Methods: A cross-sectional observational study conducted on 112 children with thalassaemia minor diagnosed by blood counts and hemoglobin electrophoresis. The iron status of all children was measured, those with a cut-off value of serum ferritin level <15 ?g/l considered to have coexistence of iron deficiency (group I), furthermore, different variables compared to the remaining children with normal serum ferritin levels (group II).

Results:Out of 112 ?-thalassemia trait children, 39 (34.82%) had concomitant iron deficiency, 35.9% females and 64.1% males, with no significant difference in sex between the two groups. The mean age ± SD was 38 ± 16 months, yet iron deficiency coincidence was significantly higher among the younger children. There was no significant difference between those with or without iron deficiency regarding hemoglobin A2 level.

Conclusions:We found that more than one third of children with thalassemia minor are also iron deficient. Furthermore, serum ferritin level didn’t impact the hemoglobin A2 in thalassaemic minor children with or without concomitant iron deficiency.

Downloads

Download data is not yet available.

References

De Benoist B, McLean E, Egli I, et al. Worldwide prevalence of anemia 1993–2005. WHO global database on anemia. 2008. Available from: http://apps.who.int/iris/bitstream/handle/10665/43894/9789241596657_eng.pdf;sequence=1

DeMaeyer E, Adiels-Tegman M. The prevalence of anemia in the world. World Health Statistics Quarterly. 1985; 38(3): 302-16.

World Health Organisation. Iron Deficiency Anaemia Assessment, Prevention, and Control: A Guide for Programme Managers. WHO. 2001. Available from:http://www.who.int/nutrition/publications/en/ ida_assessment_prevention_control.pdf

Kamil K, Mohammad N, Al-Zaidi J, et al. A Laboratory Study of Anemia in Children Aged 6 Months to 6 Years in Erbil City. Medical Journal of Babylon. 2014; 11(2): 274-84.

Nazdar E. Risk Factors Associated with Iron Deficiency Among Children Admitted to Paediatric Emergency Unit in Erbil, Iraq. Zanco J. Med. Sci. 2010; 14(3): 33-40.

Harthoorn-Lasthuizen EJ. Erythrocyte zinc protoporphyrin in the diagnosis of iron deficiency. Academic thesis, Vrije University Amsterdam. 2000; 2: 26–7.

Labbe R, Rettmer R. Zinc protoporphyrin: A product of iron-deficient erythropoiesis. Semin Hematol. 1989; 26: 40-6.

Kliegman R, Stanton B, Behrman R, et al. Nelson textbook of pediatrics. 20th ed. Phialdelphia: Elsevier; 2016; 455: 2323-6.

Green R. Nutritional Anemia. In: K Kottke-Marchant and B.H. Davis. Laboratory Hematology Practice. Wiley-Blackwell. 2012; 45: 586.

Cook J, Lipschitz D, Miles L, et al. Serum ferritin as a measure of iron stores in normal subjects. Am J Clin Nutr. 1974; 27: 681-7.

Higgs D, Engel J, Stamatoyannopoulos G. Thalassaemia. The Lancet. 2012; 379: 373-83.

Weatherall D, Clegg J. The thalassemia syndromes. 4th ed. Blackwell Science, Oxford, 2001.

Pediatric Thalassemia Treatment & Management (http://emedicine. medscape.com/article/958850-treatment)

Weatherall D, Clegg J. Inherited hemoglobin disorders: an increasing global health problem. Bulletin of the WHO. 2001; 79(8): 704-12.

Polus R. Prevalence of hemoglobinopathies among marrying couples in Erbil province of Iraq. Iraqi J Hematol. 2017; 6: 90-3.

Abdulkadir A, Huda A. Prevalence of ?-thalassemia carriers among a cohort of university students in Hawler province of Iraqi Kurdistan. Iraqi J Pharm Sci. 2009; 18(2): 15-9.

Fischbach F, Dunning MB III. Manual of Laboratory and Diagnostic Tests.8th ed. Philadelphia: Lippincott Williams and Wilkins; 2009.

Hinchliffe R, Lilleyman J. Frequency of coincident iron deficiency and beta thalassemia trait in British Asian children. J Clin Pathol. 1995; 48(6): 594–5.

Nobili B, Perrotta S, Matarese S, et al. Evaluation of body iron status in Italian carriers of the beta-thalassemia trait. Nutr Res. 2001; 21: 55-60.

Anshuman P, Baishakhi P, Soma S, et al. Frequency of Coincident Iron Deficiency among Children with Thalassemia Trait. IOSR JDMS. 2015; 14: 20-6.

Asma S, Gereklioglu C, Erdogan AF, et al. Prevalence of iron, folic acid, and vitamin B12 deficiency in patients with thalassemia minor. TJFMPC. 2013; 7(4): 83-6.

Madan N, Sikka M, Sharma S, et al. Phenotypic expression of hemoglobin A2 in? Thalassemia Trait with iron deficiency. Ann. Hematol. 1998; 77: 93-6.

Economidou J, Augustaki O, Georgiopoulou V, et al. Assessment of iron stores in subjects heterozygous for beta-thalassemia based on serum ferritin levels. Acta Haematol. 1980; 64(4): 205-8.

Dolai T, Nataraj K, Sinha N, et al. Prevalence of iron deficiency in thalassemia minor: a study from tertiary hospital. Indian Journal of Hematology and Blood Transfusion. 2012; 28(1): 7-9.

Saraya A, Kumar R, Kailash S, et al. Iron deficiency in beta- heterozygous thalassemia. The Indian Journal of Medical Research. 1984; 79: 68–75.

Alperin J, Dow P, Petteway M. Hemoglobin A2 levels in health and various hematologic disorders. American Journal of Clinical Pathology. 1977; 67(3): 219-26.

Qureshi T, Anwar M, Ahmed S, et al. Serum ferritin levels in carriers of ?-thalassemia trait. Acta Haematologica. 1995; 94(1): 7-9.

El-Agouza I, Abu Shahla A, Sirdah M. The effect of iron deficiency anemia on the levels of hemoglobin subtypes: possible consequences for clinical diagnosis. Clinical and Laboratory Haematology. 2002; 24(5): 285-9.

Wasi P, Disthasongchan P, Nakorn S. The effect of iron deficiency on the levels of hemoglobins A2 and E. The Journal of Laboratory and Clinical Medicine. 1968; 71(1): 85-91.

Kurlekar N, Mehta BC. Haemoglobin A2 levels in iron deficiency anemia. Indian Journal of Medical Research. 1981; 73(1): 77-81.

Passarello C, Giambona A, Cannata M, et al. Iron deficiency does not compromise the diagnosis of high HbA2. thalassemia trait. Haematologica. 2012; 97(3): 472-3.

Usman M, Moinuddin M, Ahmed SA. Role of iron deficiency anemia in the propagation of beta thalassemia gene. Korean Journal of Hematology. 2011; 46: 41-4.

Downloads

Published

2023-04-26

How to Cite

Hamoodi, Q. R., & Al-Ani, M. H. . (2023). Concomitant Iron Deficiency with B-Thalassaemia Minor in Preschool Children in Erbil City. AMJ (Advanced Medical Journal) , 4(2), 37-42. https://doi.org/10.56056/amj.2018.57

Issue

Section

Articles