Iron Dysregulation in Sickle Cell Disease: Trend and Clinical Implications

Abstract

Iron imbalance in sickle cell disease (SCD) is a complex puzzle that leads to persistent hemolysis, recurrent transfusions, and dysregulated iron metabolism. This brief review examines the key trends in iron homeostasis, overload, and deficiency in SCD, exploring the underlying mechanisms, clinical implications, and therapeutic approaches. Iron overload frequently arises from transfusion therapy, although iron shortage may also result from heightened erythropoietic demand and inflammation. We highlight the functions of serum ferritin, transferrin saturation (TSAT), hepcidin, and new biomarkers, as well as therapeutic strategies encompassing chelation and innovative treatments. This review synthesizes current findings, identifies knowledge gaps, and suggests future research directions to enhance iron-related outcomes in sickle cell disease (SCD).

Keywords:

Sickle cell disease, iron overload, iron deficiency, transfusion, chelation therapy, hemolysis, Iron, Ferritin, TSAT

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