Overt iron deficiency in sickle cell disease

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Abstract
Overt Fe deficiency was diagnosed in 4 patients with sickle cell disease. Three patients had homozygous SS and 1 had Hb SC disease. The cause in each case was proved or suspected blood loss. Fe repletion was accompanied by increases in the blood Hb and hematocrit levels, erythrocyte mean corpuscular volume and mean corpuscular Hb concentration (MCHC), and by change in the RBC [red blood cell] morphologic characteristics from hypochromic microcytic to normochromic normocytic. The diagnosis of Fe deficiency was confirmed by the finding of a low serum ferritin level, a high serum total Fe-binding capacity or both. Two patients who had had no painful crises while they were Fe-deficient began having crises again; another patient had painful crises for the 1st time after the blood values improved. Whether a lowered MCHC is beneficial to patients with sickle cell disease is an important but unanswered question.