BackgroundMicrocytic anemia, the most common form of anemia in children and adolescents, is a heterogeneous group of diseases that is acquired or inherited. We assessed the frequency and causes of microcytosis in children and adolescents with the sick...
BackgroundMicrocytic anemia, the most common form of anemia in children and adolescents, is a heterogeneous group of diseases that is acquired or inherited. We assessed the frequency and causes of microcytosis in children and adolescents with the sickle cell trait (SCT).MethodsThis descriptive study included 95 subjects (49 males and 46 females) with SCT who at-tended Basra Center for Hereditary Blood Diseases for evaluation. Investigations in-cluded complete blood count, high performance liquid chromatography, capillary elec-trophoresis, and measurement of serum ferritin and transferrin levels.ResultsSCT subjects had a low hemoglobin (Hb) concentration (9.79±1.75 g/dL), low mean cor-puscular volume (MCV, 67.43±9.22), low mean corpuscular Hb (21.15±3.64), and a normal red cell distribution width (RDW, 14.00±2.30). Among 95 SCT subjects, 81 (85.26%) had microcytosis, 12 (12.63%) had normal MCV, and 2 (2.11%) exhibited macrocytosis. Sixty-three (77.78%) SCT subjects with microcytosis were iron deficient, and 18 (22.22%) had normal iron levels. The mean serum ferritin and HbA2 levels were significantly lower, while the RDW, sickle Hb, and serum transferrin levels were sig-nificantly higher in patients with microcytosis and iron deficiency compared to non-iron deficient subjects (P<0.05). Correlation coefficients did not reveal a significant associa-tion between the MCV and iron status of SCT subjects (P>0.05).ConclusionDespite the frequent occurrence of iron deficiency in SCT subjects, co-inheritance of al-pha-thalassemia seemed to be the cause of low MCV in non-iron deficient individuals with microcytosis. Genetic analysis is required to understand the genetic basis of this phenomenon.