ISSN 2997-1036
International Journal of Hematology | Vol. 6, No. 4, April 2015 | pp. 25–32
DOI: 10.46882/2015/IJH/000064
Original Article
Title: Association between serum soluble transferrin receptor levels and macrovascular complications in adult sickle cell anemia patients
Names of Authors: S. T. Adeyemi¹, U. V. Okoye², W. X. Salami³
Authors’ Affiliations: ¹Department of Haematology and Blood Transfusion, Obafemi Awolowo University, Ile-Ife, Nigeria; ²Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria; ³Department of Paediatrics, Ahmadu Bello University, Zaria, Nigeria
Abstract: Chronic hemolysis in sickle cell anemia induces compensatory erythroid hyperplasia and endothelial damage, increasing the risk of macrovascular events. This study cross-sectionally evaluated the relationship between serum soluble transferrin receptor (sTfR) levels, a biomarker for erythroid marrow activity, and macrovascular complications, including ischemic stroke and pulmonary hypertension indices, in 92 adult patients with stable sickle cell anemia (HbSS). Serum sTfR was measured using an enzyme-linked immunosorbent assay, and pulmonary hypertension risk was estimated via tricuspid regurgitant jet velocity on Doppler echocardiography. Patients with elevated sTfR levels (≥ 8.5 μg/ml) showed a significantly higher mean tricuspid regurgitant jet velocity (2.85 ± 0.35 m/s versus 2.15 ± 0.20 m/s in lower sTfR cohorts, P < 0.01). A history of stroke correlated positively with high sTfR concentrations (odds ratio = 3.24, P < 0.05). Furthermore, sTfR levels correlated inversely with total hemoglobin values (r = -0.54, P < 0.001) and positively with serum lactate dehydrogenase. Elevated soluble transferrin receptor concentrations reflect intense erythroid drive linked to chronic hemolysis, serving as a useful biomarker for identifying patients vulnerable to severe hemolytic endothelial phenotypes and macrovascular injury.
Keywords: Sickle cell anemia, soluble transferrin receptor, chronic hemolysis, pulmonary hypertension, stroke
Manuscript Timeline: Received: January 08, 2015; Revised: February 18, 2015; Accepted: March 08, 2015; Published: April 14, 2015