ISSN 2997-1036
International Journal of Hematology | Vol. 13, No. 9, September 2022 | pp. 65–72
DOI: 10.46882/2022/IJH/000151
Original Article
Title: Serum hepcidin-25 kinetics and iron profiling updates in pregnant women presenting with severe microcytic anemia
Names of Authors: A. I. Ibrahim¹, C. D. Balogun², E. O. Ojo³
Authors’ Affiliations: ¹Department of Haematology, Ahmadu Bello University, Zaria, Nigeria; ²Department of Obstetrics and Gynaecology, University of Ilorin, Ilorin, Nigeria; ³Department of Chemical Pathology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
Abstract: Managing microcytic anemia during gestation requires distinct differentiation between absolute nutritional iron depletion and functional iron blockades driven by subclinical inflammatory states. This prospective study evaluated serum hepcidin-25 kinetics, soluble transferrin receptor (sTfR) levels, and total hemoglobin variations in 85 pregnant women in their third trimester presenting with severe microcytosis (MCV < 70 fl). Bioactive serum hepcidin-25 concentrations were quantified via a competitive enzyme-linked immunosorbent assay. Pregnant individuals with true iron deficiency anemia exhibited complete suppression of serum hepcidin-25 levels (< 1.5 ng/ml) paired with marked elevation of soluble transferrin receptor levels. Conversely, a sub-population presenting with concurrent chronic infections demonstrated paradoxically elevated hepcidin-25 concentrations (mean 24.5 ± 4.2 ng/ml) despite low serum iron parameters, reflecting an inflammatory iron trap. Hepcidin levels correlated positively with serum ferritin metrics (r = 0.62, P < 0.001). Integrating quantitative hepcidin-25 evaluations into gestational screening algorithms provides superior diagnostic security, allowing clinicians to bypass ineffective oral iron replenishment steps and identify functional anemia variants requiring targeted anti-inflammatory or intravenous management.
Keywords: Hepcidin-25, pregnancy, iron deficiency anemia, anemia of chronic disease, soluble transferrin receptor
Manuscript Timeline: Received: June 15, 2022; Revised: July 24, 2022; Accepted: August 12, 2022; Published: September 15, 2022