Iron overload in adults with sickle cell disease who have received intermittent red blood cell transfusions. Issue 10 (25th February 2015)

• Record Type: Journal Article
• Authors: Pack‐Mabien, Ardie; Brown, Brittany; Herbert, Donald E.; Haynes, Johnson
• Is Part Of: Journal of the American Association of Nurse Practitioners. Volume 27:Issue 10(2015)
• Page Start: 591
• Page End: 596
• Publication Date: 2015-02-25
• Subjects: Nurse practitioners -- Periodicals; Nursing -- Periodicals; 610.730692
• DOI: 10.1002/2327-6924.12221
• Languages: English
• ISSNs: 2327-6886

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jaan12221-sec-0010" sec-type="section"> <title>Objective</title> <p>To assess the prevalence of iron overload in adults with sickle cell disease (SCD) not on a chronic transfusion protocol.</p> </sec> <sec id="jaan12221-sec-0020" sec-type="section"> <title>Design</title> <p>Retrospective chart review.</p> </sec> <sec id="jaan12221-sec-0030" sec-type="section"> <title>Data source</title> <p>University of South Alabama Comprehensive Sickle Cell Center adult outpatient clinic.</p> </sec> <sec id="jaan12221-sec-0040" sec-type="section"> <title>Results</title> <p>There was no significant difference in units transfused across the four genotypes (HbSS, HbSC, HbSβ<sup>0</sup>‐thalassemia, and HbSβ<sup>+</sup>‐thalassemia). Only individuals with HbSS (<italic>n</italic> = 63) met criteria for iron overload with ferritins of ≥1500 ng/mL. Forty‐eight had ferritins <1500 ng/mL, eight (13%) had ferritins ≥3000 ng/mL, and seven (11%) had ferritins ≥1500 and <3000 ng/mL. The overall prevalence of iron overload was 9.74% in SCD cohort and 23.8% in the HbSS genotype.</p> </sec> <sec id="jaan12221-sec-0050" sec-type="section"> <title>Conclusions</title> <p>Our data support that patients with HbSS are at a particularly high risk for inadvertent iron overload as compared to HbSC, HbSβ<sup>0</sup>‐thalassemia, and HbSβ<sup>+</sup>‐thalassemia.</p> </sec> <sec id="jaan12221-sec-0060" sec-type="section"> <title>Implications for practice</title> <p>This study supports the need for healthcare providers to closely monitor the number of red blood cell (RBC) transfusions, RBC units transfused, and serial baseline, steady‐state ferritin levels. With closer monitoring, the clinical significance of iron overload in SCD can be established and guide the healthcare provider's management in the prevention of iron overload.</p> </sec> </abstract>