Reddy Naramreddy Sudheesh, Vagha Keta, Varma Ashish, Javvaji Chaitanya Kumar
Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Sep 24;16(9):e70087. doi: 10.7759/cureus.70087. eCollection 2024 Sep.
Background Sickle cell disease (SCD) and iron deficiency anemia (IDA) are significant global health concerns, particularly in pediatric populations. This study investigates the prevalence, clinical impact, and management challenges of IDA in children with SCD. Methods A prospective observational study was conducted at the Department of Pediatrics, Jawaharlal Nehru Medical College(JNMC) and Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, from June 2022 to May 2024. The study included 60 children diagnosed with SCD. Comprehensive assessments were performed, including medical histories, physical examinations, and hematological investigations. Diagnosis of IDA was based on hemoglobin levels, mean corpuscular volume (MCV), red cell distribution width (RDW), peripheral blood smears, serum iron levels, and serum ferritin concentrations. Results Of the 60 participants, 15% exhibited iron deficiency. No significant gender differences were found in iron deficiency status. A significant association was observed between SCD type and the presence of pallor (p = 0.025) and sickle cell crises (p = 0.023). The study also found no significant association between SCD type and the presence of organomegaly (p = 0.079) or iron deficiency status (p = 0.675). The mean hemoglobin levels varied across SCD types, with sickle cell anemia patients showing lower levels than those with sickle cell trait or disease. Conclusion Diagnosing and managing IDA in children with SCD is complex due to overlapping hematological features and the risk of iron overload from frequent transfusions. Tailored diagnostic and therapeutic approaches are essential to improving hemoglobin levels, reducing complications, and enhancing the quality of life for affected children. This study provides valuable insights for refining clinical practices and emphasizes the need for a multidisciplinary approach to managing these intertwined conditions.
镰状细胞病（SCD）和缺铁性贫血（IDA）是全球重大的健康问题，在儿科人群中尤为突出。本研究调查了SCD患儿中IDA的患病率、临床影响及管理挑战。方法：于2022年6月至2024年5月在贾瓦哈拉尔尼赫鲁医学院（JNMC）儿科和萨旺吉的阿查里亚·维诺巴·巴韦农村医院（AVBRH）进行了一项前瞻性观察研究。该研究纳入了60名被诊断为SCD的儿童。进行了全面评估，包括病史、体格检查和血液学检查。IDA的诊断基于血红蛋白水平、平均红细胞体积（MCV）、红细胞分布宽度（RDW）、外周血涂片、血清铁水平和血清铁蛋白浓度。结果：60名参与者中，15%表现出缺铁。缺铁状态在性别上无显著差异。观察到SCD类型与面色苍白（p = 0.025）和镰状细胞危象（p = 0.023）之间存在显著关联。该研究还发现SCD类型与肝脾肿大（p = 0.079）或缺铁状态（p = 0.675）之间无显著关联。不同SCD类型的平均血红蛋白水平有所不同，镰状细胞贫血患者的水平低于镰状细胞性状或疾病患者。结论：由于血液学特征重叠以及频繁输血导致铁过载的风险，诊断和管理SCD患儿的IDA较为复杂。量身定制的诊断和治疗方法对于提高血红蛋白水平、减少并发症以及提高受影响儿童的生活质量至关重要。本研究为完善临床实践提供了有价值的见解，并强调了采用多学科方法管理这些相互交织的病症的必要性。
