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Pediatrics Education and Research

Volume  8, Issue 1, January-March 2020, Pages 25-29
 

Original Article

Iron Toxicity Measurement by Serum Ferritin Levels Due to Blood Transfusion in Patients of Thalassemia Major

Ajit Inder Kaur1, Sanjay Chavan2, SR Agarkhedkar3, D Upase4

1Resident, 2Professor, 3Professor and Head, Department of Pediatrics, 4Consultant Hematologist and Oncologist, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra 411018, India.

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DOI: https://dx.doi.org/10.21088/per.2321.1644.8120.4

Abstract

Introduction: Thalassemia is genetic blood disorders inherited from a person’s parents that can result in the abnormal formation of hemoglobin. In beta thalassemia major ineffective erythropoiesis, frequent blood transfusions lead to iron overload. Excessive iron can cause irreversible organ damage. Iron overload can be measured by serum ferritin levels. Aims and objectives: To study iron toxicity due to blood transfusion in patients of thalassemia major. To study the correlation between iron toxicity and serum ferritin levels. Correlation between iron toxicity and number of blood transfusions. To study growth parameters in thalassemia penitents pertaining to iron toxicity. Methods: Fifty cases of thalassemia major were enrolled. Detailed history and clinical examination was done and blood samples collected to test for serum ferritin levels. Ferritin levels were performed by using indirect enzyme-linked immunosorbent assay (ELISA) kit along with normal and abnormal controls. Data were analyzed to determine the association between variables. Results: Majority of the patients were in ≤5 years of age (40%) followed by 6–10 years (32%). Sixty-four percent subjects were male and 36% were female. At baseline majority of the children (44%) were having serum ferritin level between 1000 and 2500 ng/ml followed by 2501 and 4000 ng/ml (32%) and 4001 and above (14%). At the last follow-up serum ferritin level was observed to be increased with majority having serum ferritin level between 1000–4000 ng/ml (68%). At the last follow-up it was observed that the total dose of iron chelator was increased as compared to baseline and was statistically significant. Conclusion: Thus we conclude that majority of the children suffering from thalassemia major were having iron toxicity due to blood transfusion at the baseline and at the last follow-up also. Increasing age and number of transfusions were significantly associated with serum ferritin levels statistically. Positive correlation between Sr. Ferritin level and chelation was observed at the baseline and at the time of last follow-up also.

Keywords: Thalassemia; Enzyme-linked immunosorbent assay (ELISA); Serum; Hemoglobin.


Corresponding Author : Ajit Inder Kaur