The Relation between Serum Hepcidin, Ferritin, Hepcidin: Ferritin Ratio, Hydroxyurea and Splenectomy in Children with β-Thalassemia

Authors

  • Nagwa Abdallah Ismail Pediatric Department, National Research Center, Cairo, Egypt
  • Sonia Adolf Habib Pediatric Department, National Research Center, Cairo, Egypt
  • Ahmed A. Talaat Pediatric Department, National Research Center, Cairo, Egypt
  • Naglaa Omar Mostafa Pediatric Hematology Department, Cairo University, Cairo, Egypt
  • Eman A. Elghoroury Clinical Pathology Department, National Research Center, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2019.636

Keywords:

Hepcidin, Splenectomy, Ferritin, Thalassemia Intermedia, Thalassemia Major

Abstract

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 β-thalassemia patients and to determine the effect of splenectomy and hydroxyurea on serum hepcidin.

METHODS: A study was conducted on 30 thalassemia major (βTM), 29 thalassemia intermedia (βTI) 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: Βeta-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. Β-TM patients had higher mean serum hepcidin and serum ferritin compared to β-TI, with statistically significant difference (P = 0.042, P < 0.001, respectively). Twenty-one patients out of 29 βTI 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 ± 14.75, 17.76 ± 10.01 ng/mL). Hepcidin showed a significantly positive correlation with hepcidin: ferritin ratio in all studied groups.

CONCLUSION: Serum hepcidin was elevated in β-thalassemia children with more evident elevation in βTM 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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Published

2019-08-14

How to Cite

1.
Ismail NA, Habib SA, Talaat AA, Mostafa NO, Elghoroury EA. The Relation between Serum Hepcidin, Ferritin, Hepcidin: Ferritin Ratio, Hydroxyurea and Splenectomy in Children with β-Thalassemia. Open Access Maced J Med Sci [Internet]. 2019 Aug. 14 [cited 2021 Oct. 24];7(15):2434-9. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.636

Issue

Section

B - Clinical Sciences

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