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Ferritin and DB in Sickle Cell Anemia
Are they associated with mortality?
Ferritin and direct bilirubin (DB) are independently associated with mortality in sickle cell disease (SCD), according to a study of 247 patients with SCD. Researchers found:
• Increased DB, ferritin, alkaline phosphatase, and decreased albumin were independently associated with mortality.
• Ferritin correlated with hepatic iron content and total blood transfusions, but not haemolysis markers.
• 40 patients underwent liver biopsies and 28% had fibrosis.
• All patients with advanced liver fibrosis had iron overload; however, most patients with iron overload were without significant hepatic fibrosis.
• Ferritin did not correlate with left ventricular dysfunction.
• B correlated with bile acid levels, suggesting liver pathology.
• Platelet count and soluble CD14 correlated with hepatic venous pressure gradient, indicating portal hypertension.
Citation: Feld JJ, Kato GJ, Koh C, et al. Liver injury is associated with mortality in sickle cell disease. [Published online ahead of print August 3, 2015]. Aliment Pharmacol Ther. doi: 10.1111/apt.13347.