ASSESSMENT OF SERUM FERRITIN IN BETA THALASSEMIA MAJOR PATIENTS: INSIGHTS FROM A THALASSEMIA CENTRE IN PAKISTAN

Abstract

Beta thalassemia major is the most common monogenic hereditary hemoglobinopathy which poses a major health burden in Pakistan. Regular transfusion of RBC’s (erythrocytes) required for survival of these patients which consequently leads to inevitable iron overload, which is demonstrated by elevated serum ferritin levels. Developing of iron excess may lead to organ damage and other life-threatening diseases. The aim of this study was to evaluate iron overload in beta thalassemia major patients in one of the thalassemia centers of Pakistan by means of their serum ferritin levels. The study was also conducted to approximate the current situation of iron overload in them. 155 blood samples of clinically diagnosed beta thalassemia major patients were collected from Jamila sultana foundation (JSF) for their serum ferritin estimation. Serum ferritin measurement was performed using indirect enzyme linked immune sorbent (ELISA) based serum ferritin assay kit. Demographics data of the patients were statistically analyzed by using SPSS 2.O and association between age, gender and serum ferritin levels were established. 85.4% of the beta thalassemia major patients showed very high ferritin levels. The mean serum ferritin level was found to be 4442 ± 2882 ng/ml. 44.4% patients had serum ferritin between 1000 to 2500 ng/ml, while 43.05% patients had values above 2500 ng/ml. Majority of the patients with high serum ferritin concentration (>2500 ng/mL) were aged more than 11 years. These levels reflect inadequate chelation and vulnerability to develop iron overload related complications. There is an urgent need to rationalize the chelation therapy and to create focus about the consequences of iron overload in these patients. The study showed elevated levels of serum ferritin beta thalassemia major patients which provide a normal bleak view.