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Serum Hepcidin as a Diagnostic Marker of Severe Iron Overload in Beta-thalassemia Major

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Abstract

Objectives

To investigate potential usefulness of serum hepcidin in the diagnosis of iron overload in children with β-thalassemia.

Methods

A study was conducted on 30 thalassemia major (TM), 30 thalassemia intermedia (TI) and 60 healthy children as controls. Serum hepcidin was measured by Human Hepcidin, ELISA Kit.

Results

β-thalassemia patients had a higher serum hepcidin compared to the controls (p < 0.001). TM group had higher hepcidin and ferritin compared to the TI group (p = 0.034; < 0.001, respectively). Among controls, hepcidin did not correlate with age (r = 0.225, p = 0.084). Among β-thalassemia patients, it correlated positively with age (r = 0.4; p = 0.001), disease duration (r = 0.5; p < 0.001), transfusion frequency (r = 0.35; p = 0.007), total number of transfusions (r = 0.4; p = 0.003), and ferritin (r = 0.3; p = 0.027). Total hemoglobin and serum ferritin were significantly related to hepcidin, which tended to increase by 0.514 ng/ml with each 1 g/dl rise in hemoglobin (p = 0.023) and by 0.002 ng/ml with each 1 ng/ml rise in serum ferritin (p = 0.002). Iron overload [serum ferritin (SF) ≥ 1500 ng/ml] was independently associated with TM (p = 0.001) and elevated serum hepcidin (p = 0.02). The overall predictability of serum hepcidin in severe iron overload was statistically significant when compared to hepcidin to serum ferritin ratio.

Conclusions

Serum hepcidin is elevated in children with β-thalassemia; but this elevation is more evident in TM patients with severe iron overload. Thus, hepcidin can be a potential marker of severe iron overload in patients with TM. Further studies are recommended to compare serum hepcidin and serum ferritin in the prediction of severe iron overload in steady state and during infection or inflammation.

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Abbreviations

TM:

Thalassemia major

TI:

Thalassemia intermedia

HC:

Hydroxycarbamide

ALT:

Alanine transaminase

AST:

Aspartate transaminase

IQR:

Interquartile range

ROC:

Receiver operating curve

AUC:

Area under the curve

SF:

Serum ferritin

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Acknowledgements

The authors are indebted to every patient included in this study and also their parents for their corporation and their trust. They wish them all the best of health and happiness.

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Cairo University, Ali Ibrahim Basha St., Cairo, Egypt

    Ahmed Maher Kaddah, Amina Abdel-Salam & Reham Ragab

  2. Department of Clinical Pathology, Cairo University, Cairo, Egypt

    Marwa Salah Farhan

Authors
  1. Ahmed Maher Kaddah
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  2. Amina Abdel-Salam
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  3. Marwa Salah Farhan
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  4. Reham Ragab
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Contributions

AMK: Idea of the study, the study plan, final editing and approval of the final copy; AA-S: Sharing in putting the study design, drafting of the article, final editing and approval of the final copy; MSF: Laboratory assays, final editing and approval of the final copy; RR: Data collection, data entry, final editing and approval of the final copy. AMK will act as guarantor for the paper.

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Correspondence to Amina Abdel-Salam.

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Kaddah, A.M., Abdel-Salam, A., Farhan, M.S. et al. Serum Hepcidin as a Diagnostic Marker of Severe Iron Overload in Beta-thalassemia Major. Indian J Pediatr 84, 745–750 (2017). https://doi.org/10.1007/s12098-017-2375-4

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  • DOI: https://doi.org/10.1007/s12098-017-2375-4

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