Erythrocyte indices of iron status in children with cyanotic congenital heart disease at the University College Hospital, Ibadan

Abstract

Background Iron (Fe) deficiency is a known feature of cyanotic congenital heart disease (CCHD) and may worsen symptoms. The prevalence of iron deficiency among children with CCHD at the University College Hospital (UCH), Ibadan is unknown. Erythrocyte indices of iron status are easier and less expensive to determine than serum iron, serum ferritin and total iron binding capacity, which are the standard tests of iron deficiency.
Objectives: To examine the erythrocyte indices of iron status in children
with CCHD in UCH, and determine the prevalence of iron deficiency
among such patients, by comparing the values obtained with established
reference values.
Subjects and Methods: The packed cell volume (PCV), haemoglobin
(Hb), mean corpuscular volume (MCV), mean corpuscular haemoglobin
concentration (MCHC) and red cell distribution width (RDW) of 40 children with CCHD, determined using a Sysmex 1000X1 Coulter counter, were compared with standard reference values.
Results: Mean+SD values obtained were – PCV: 58.6+11.6%. MCV:
80.7+12.1 ìm3, MCH: 25.9+9.5g/dl, MCHC: 30.9+4.1 and RDW:
20.5.5+12.6%. Lower-than-normal values for MCV, MCH and MCHC were
found in 33.5%, 42.5% and 72.5% of patients, respectively, while
77.5% had higher-than-normal values for RDW. However, using the
criteria based on a combination of RDW and MCV, 35% of patients
were iron deficient.
Conclusion: A large proportion of Nigerian children with CCHD appear
to be iron deficient and are therefore likely to benefit from routine
iron therapy.