The Role of Erythropoiesis on Hepcidin Level in Polytransfused b-Thalassemia Major Patients | ||||
The Medical Journal of Cairo University | ||||
Article 15, Volume 86, December, December 2018, Page 3493-3497 PDF (404.69 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/mjcu.2018.60589 | ||||
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Authors | ||||
EMAN M.N. ABD EL-SALAM, M.D.; MARWA M.M. TOLBA, M.Sc.; MAHMOUD Y. EL-TAHTAWY, M.D.; TAGHREED K. EL-DEIN, M.D.; WAFAA S. MOHAMMED, M.D.; MOSTAFA M. EMBABY, M.D.; KHALED A. NASIF, M.D.; EBTESAM M. EL-GEZAWY, M.D. | ||||
Abstract | ||||
Abstract Background: Hepcidin peptide hormone is a main con-troller of iron homeostasis, itbecomes elevated in case of iron overload, however despite iron overload in b-Thalassemia major (b-TM) patients a contradictory decrease in Hepcidin occurs. The incompatible Hepcidin level is the main responsible factor causing the iron overload status in iron-loading anemias such as (b-TM) which contributes to organ dysfunctionand to iron toxicity. Aim of Study: To evaluate the conflicting effect of increased erythropoiesis in contrast to the effect of iron overloading on Hepcidin serum level and its correlation with iron status in (b-TM) patients. Subjects and Methods: For all patients and controls Complete Blood Count (CBC), serum assaysof Hepcidin, iron, ferritin, transferrin, HCVAbs, HBs Ag, CRP and serum level were performed. Results: Hepcidin level was significantly lowered in (b-TM) patients compared to controls with high significant difference (p=0.00). There was no correlation between serum Hepcidin and ferritin level, neither was between Hepcidin and serum iron, transferrin, Hb level and reticulocyte count in the study group. Hepcidin/Ferritin ratio showed high significance difference (p<0.000) with mean value in the study group 0.056 vs. 4.75 in controls pointing to an incom-patible levels of Hepcidin to iron overload status. Hepcidin level wasnegative correlatedwith age (p<0.05). Conclusion: Hepcidin was markedly decreased in the study group with no significant correlation between serum Hepcidin and ferritin level as a marker of iron overload in thalassemia major. Hepcidin deficiency is the main contributing factor of iron overload in b thalassemia which results from a strong suppressive effect of the high erythropoietic activity on Hepcidin expression. Hepcidin-ferritin ratio was markedly depressed <1 in all b thalassemia major patients which indicating suppression of Hepcidin out of proportion with the degree of iron loading. | ||||
Keywords | ||||
Hepcidin – Iron – Thalassemia – Transferrin – Ferritin | ||||
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