Frequency of Iron Deficiency and Iron Deficiency Anemia among Hemophilia Children in Babylon Hereditary Blood Disease Center /Iraq

Subject Areas : Journal of Chemical Health Risks

Ahmed Shemran Mutlaq Al-Wataify ¹ , Hussain Naji Al-Shammary ² , Amna Ganem Abdul-hussain ³ , Qasim Fakher Alhussainy ⁴

1 - Professor of Pediatric, Deptartment of Pediatric, Collage of Medicine, University of Babylon, Hilla, Iraq FRCP, CABP, FICMS pediatric
2 - Associate Professor of Hematology, College of Medicine, Babylon University, General Pathology, Hematology, Hilla, Iraq, MB.Ch.B. FICMS, Hematology
3 - Pediatrition, Babylon Health Directorate, Iraqi Mministryof Health, Hilla, Iraq, M.B.CH.B, F.I.C.M.S.
4 - Pediatrition, Babylon Health Directorate, Iraqi ministry of health. Hilla, Iraq, M.B.CH.B, F.I.C.M.S.

Received: 2021-08-05 Accepted : 2021-11-25 Published : 2022-06-01

Keywords: Iron Deficiency Anemia, Arthropathy, Hemophilia, Iron deficiency joint bleeding, Serum ferritin,

Abstract :

Objective: to evaluate the frequency of iron deficiency with or without anemia among hemophilia patients with its correlation with other factors including age, address, type and severity of hemophilia. Study design: Cross sectional study, it was conducted at Babylon hereditary blood disease center at Babylon Government/Iraq. For a period of 10 months, from 1st of February to end of November 2019. Methods: The study included 60 patients of hemophilia classified into: hemophilia A (40) patients and hemophilia B (20) patients; all of them were males; age ranged from 6 months to 15 years. All patients were sent for white blood cells count, Hb, Red blood cells indices, serum ferritin level, ESR, C-reactive protein and virology screening. Results: The study reveals IDA occurred in 28.3% and 58.3% of patients developed ID. There was more declined in mean ferritin level among patients with IDA reached 3.7 ± 1.4 ng ml-1 , compared to 5.7± 1.4 ng ml-1 in ID and in those with sever deficiency. Higher percentage of ID and IDA occurred in complicated hemophilia and those were lived in rural areas. Conclusion: Iron deficiency and IDA are common among hemophilia patients.

References:

1. Ghosh K., Ghosh K., 2016. Management of haemophilia in developing countries: challenges and options. Indian Journal of Hematology and Blood Transfusion. 32(3), 347-355.


2. Tantawy A.A., 2010. Molecular genetics of hemophilia A: Clinical perspectives. Egyptian Journal of Medical Human Genetics. 11(2), 105-114.


3. Young G., 2012. New challenges in hemophilia: long-term outcomes and complications. Hematology 2010. The American Society of Hematology Education Program Book. 2012(1), 362-368.


4. Klamroth R., Pollmann H., Hermans C., Faradji A., Yarlas A. S., Epstein J.D., Ewenstein B.M., 2011. The relative burden of haemophilia A and the impact of target joint development on health related quality of life: results from the ADVATE Post Authorization Safety Surveillance (PASS) study. Haemophilia.17(3), 412-421.


5. McLean E., Cogswell M., Egli I., Wojdyla D., De Benoist B., 2009. Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993–2005. Public Health Nutrition. 12(4), 444-454.


6. Scott J., Montgomery R., 2010. Hemorrhagic and thrombotic disorder. Saunder. Philadelphia.


7. Nieuwenhuizen L., Schutgens R., Van Asbeck B., Wenting M., Van Veghel K., Roosendaal G., Biesma D., Lafeber F., 2013. Identification and expression of iron regulators in human synovium: evidence for upregulation in haemophilic arthropathy compared to rheumatoid arthritis, osteoarthritis, and healthy controls. Haemophilia. 19(4), e218-e227.


8. Ahmed S.G., Kagu M.B., Ibrahim U.A., Bukar A.A., 2015. The frequency of iron deficiency among patients with haemophilia-A in northern Nigeria: correlation with the disease severity and clinical implications. The Egyptian Journal of Haematology. 40(2), 85.


9. Kosiakova I.A., Davydkin I., Zorenko V.I., 2014. Mechanisms of comorbidity in hemophilia patients. Terapevticheskii Arkhiv. 86(3), 78-82.


10. Ibrahim U.A., Ahmed S.G., Kagu M.B., Abjah U.A., 2017. Impact of intestinal helminths on the risks of gastrointestinal haemorrhage and iron deficiency among haemophilia patients in northern Nigeria. J Haem Pract 4 (1),1-8.


11. Soppi E., 2019. Iron deficiency without anemia–common, important, neglected. Clin Case Rep Rev. 5, 1-7.


12. Bhatnagar N.D., Haematology L.P., 2017. By BJ Bain, I. Bates and MA Laffan. British Journal of Haematology. 178, 652–652.


13. Poongavanam P., Nandakumaran J., Shanmugam M., Pachuau H., 2017. The Frequency of Iron Deficiency among Patients with Hemophilia. IOSR Journal of Dental and Medical Sciences. 16, 4-9.


14. Haque R., Biswas D.A., Quraishi S.A., 2018. Study of anemia among hemophilia patients. Bangladesh Journal of Medical Science. 17(4), 573-575.


15. Özdemir N., 2015. Iron deficiency anemia from diagnosis to treatment in children. Turkish Archives of Pediatrics/Türk Pediatri Arşivi. 50(1), 11.


16. Janus J., Moerschel S.K., 2010. Evaluation of anemia in children. American Family Physician. 81(12), 1462-1471.