Assessing and managing iron deficiency anemia in sickle cell disease: Insights from a systematic review and meta-analysis

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#humans #anemia-iron-deficiency #anemia-sickle-cell #ferritins #prevalence

Assessing and managing iron deficiency anemia in sickle cell disease: Insights from a systematic review and meta-analysis

Jose et al., 2025 | J Postgrad Med | Meta Analysis

Citation

Jose A, Bodade A, Madkaikar M R. Assessing and managing iron deficiency anemia in sickle cell disease: Insights from a systematic review and meta-analysis. J Postgrad Med. 2025-Jan-01;71(1):33-40. doi:10.4103/jpgm.jpgm_590_24

Abstract

Sickle cell disease (SCD) is prevalent in Sub-Saharan Africa, the Middle East, and parts of India, where it is often complicated by iron deficiency anemia (IDA). Untreated IDA exacerbates SCD symptoms, reducing quality of life (QOL) and increasing morbidity and mortality. Diagnosis typically depends on ferritin levels, which can be unreliable due to inflammation associated with SCD's altered red cell morphology and chronic hemolysis. This systematic review and meta-analysis explores the interplay between IDA and SCD, focusing on diagnostic criteria for effective management. We conducted a thorough search of PubMed and EMBASE, leading to the selection of 14 studies following PRISMA guidelines. The review protocol was registered in PROSPERO (CRD42023462914). Data extraction, quality assessments, and heterogeneity checks were rigorously performed. Out of 3188 articles, 14 studies met the inclusion criteria, covering 763 SCD cases with 118 instances of IDA. The meta-analysis found an IDA prevalence of 6% (95% CI: 1%-20%) among SCD patients, with high heterogeneity (I 2 = 88.8%). Sensitivity analysis adjusted for publication bias indicated an 8% prevalence (95% CI: 4%-19%) with reduced heterogeneity (I 2 = 19.5%). Subgroup analysis revealed a lower prevalence of IDA in pregnant women (0.01%; 95% CI: 0.00%-0.92%) compared to non-pregnant individuals (7%; 95% CI: 2%-22%). The study highlights significant regional variability in IDA prevalence among SCD patients, emphasizing the importance of early diagnosis and targeted management to improve patient outcomes and QOL.

Key Findings

The study highlights significant regional variability in IDA prevalence among SCD patients, emphasizing the importance of early diagnosis and targeted management to improve patient outcomes and QOL.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population pregnant women
Sample Size 14
Age Range See abstract
Condition deficiency

MeSH Terms

  • Humans
  • Anemia, Iron-Deficiency
  • Anemia, Sickle Cell
  • Ferritins
  • Prevalence
  • Quality of Life

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis
  • Vertical: iron

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09