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

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.