Iron studies in patients with sickle cell disease.

The prevalence of iron deficiency anaemia during the first three decades of life was investigated in eighty-five patients with SS and SC haemoglobins. The parameters used were the haematocrit, serum iron, total iron binding capacity (TIBC), percentage saturation of transferrin and availability of iron in the bone marrow. The mean haematocrit values were similar throughout the three decades, but increased with age (r = 0.41). The mean serum iron was significantly lower (P less than 0.01) in the first decade than in the second or third decade. Females had lower serum iron in the first and second decades and higher values in the third decade than their male counterparts. The transferrin saturation was significantly lower (P less than 0.01) in the first decade than in the third decade. No haemosiderin was found in the marrow aspirates at a transferrin saturation of less than or equal to 15%. Of the eighty-five bone marrow aspirates studied for stainable iron, fifty-eight (68.2%) had nil iron. The data presented show that iron deficiency anaemia is a common finding in patients with haemoglobinopathies. The need to incorporate oral iron with folic acid and paludrine in the treatment of sickle cell disease is suggested.