The Relation between Serum Hepcidin, Ferritin, Hepcidin: Ferritin Ratio, Hydroxyurea and Splenectomy in Children with Î²-Thalassemia
Keywords:Hepcidin, Splenectomy, Ferritin, Thalassemia Intermedia, Thalassemia Major
BACKGROUND: Hepcidin, a small peptide hormone, is established as the main regulator of iron homeostasis.
AIM: To estimate serum hepcidin, ferritin, and hepcidin: ferritin ratio in Î²-thalassemia patients and to determine the effect of splenectomy and hydroxyurea on serum hepcidin.
METHODS: A study was conducted on 30 thalassemia major (Î²TM), 29 thalassemia intermedia (Î²TI) and 29 healthy children's controls. Data were collected by patient interviewing where detailed history-taking and thorough clinical examinations were carried out. Serum ferritin and hepcidin were measured by ELISA assay (Bioneovan Co. Ltd Beijing, China).
RESULTS: Î’eta-thalassemia patients had higher serum ferritin, serum hepcidin and lower Hb and hepcidin: ferritin ratio compared to the controls (p < 0.001, 0.010, 0.001, 0.001) respectively. Î’-TM patients had higher mean serum hepcidin and serum ferritin compared to Î²-TI, with statistically significant difference (P = 0.042, P < 0.001, respectively). Twenty-one patients out of 29 Î²TI was on hydroxyurea therapy; these patients had significantly lower levels of serum ferritin (P < 0.004) and significantly higher levels of Hb (P < 0.004). Serum ferritin was statistically significantly higher in splenectomized patients P < 0.009. Serum hepcidin level was insignificantly higher in splenectomized patients than non-splenectomized patients (21.6 Â± 14.75, 17.76 Â± 10.01 ng/mL). Hepcidin showed a significantly positive correlation with hepcidin: ferritin ratio in all studied groups.
CONCLUSION: Serum hepcidin was elevated in Î²-thalassemia children with more evident elevation in Î²TM patients. Splenectomy played no major role in hepcidin regulation. Knowing that hepcidin in serum has a dynamic and multi-factorial regulation, individual evaluation of serum hepcidin and follow up, e.g. every 6 months could be valuable, and future therapeutic hepcidin agonists could be helpful in management of iron burden in such patient.
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Copyright (c) 2019 Nagwa Abdallah Ismail, Sonia Adolf Habib, Ahmed A. Talaat, Naglaa Omar Mostafa, Eman A. Elghoroury (Author)
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