Sickle Cell Disease and Risk for Iron Overload

A common and inherited blood disorder in the United States, sickle cell disease affects 1 in 500 African Americans and 1 in 1000 Hispanic Americans. Although it's more common in these ethnic groups, sickle cell disease can occur in people of all races.

In sickle cell disease, there's too little oxygen in red blood cells. This condition makes the blood cells rigid. Instead of being round, they become deformed and elongated or crescent (sickle) shaped. Because the cells are no longer supple, they don't move easily through blood vessels, can cause blockages, and prevent tissues throughout the body from getting enough oxygen.

Sickle cell disease can sometimes be painful. For example, blockages in the lungs can be painful and make it difficult to breathe. And blockages in the limbs can cause the arms and legs to swell and be painful. Other complications from sickle cell disease include leg ulcers, gallstones, high blood pressure in the lungs, an enlarged spleen, and stroke.

Some people with sickle cell disease have blood transfusions to help reduce complications of the disease. Although transfusions can help improve the quality of life for people with sickle cell disease, they add extra iron to the body. Because the extra iron does not go away by itself, it can build up and overload the body. People with sickle cell disease who've had 10 or more transfusions in a lifetime are at risk for iron overload. And iron overload can damage the heart, liver, and other organs.

The good news is that a simple blood test called a serum ferritin test can help you find out if you have iron overload. Ask your doctor if the serum ferritin test is right for you. Then be sure to talk with your doctor about iron overload, your risk, screening and diagnosis, and how to manage iron overload.

If you continue to have blood transfusions, remember that it's important to stay on track with monitoring to be sure your iron levels are where they should be. Ask your doctor when you should be tested to find out if your iron levels have changed.