Erythroferrone and Hepcidin Levels in Children with Iron Deficiency Anemia

Abstract Purpose: In the study, it was aimed to determine the correlation between erythroferrone (ERFE) and hepcidin levels in patients with iron deficiency anemia and laboratory parametersused in diagnosing iron deficiency anemia, and to investigate whether the drugs that may lead to an increase in EFTE or will suppress hepcidin could be new treatmentmodalities in iron deficiency anemia. Method: 26 cases who presented to the pediatrics clinic with a diagnosis of iron deficiency anemia and did not have a concomitant disease and 26 healthy children were included in the study. In the study conducted with a case-control design, normal hemoglobin and hematocrit lower limits according to age and gender and red cell indices based on normal age and gender determined by the World Health Organization were used for the diagnosis of anemia. In order to evaluate iron status, serum iron, total iron binding capacity (TIBC), and ferritin levels were analyzed. Serum hepcidin and erythroferrone levels in children diagnosed with iron deficiency before the start of the iron treatment and at the end of first month of their treatment and in the control group were measured with ELISA method. Findings: Compared to the control group, hemoglobin (p < 0,001), MCV (p = 0,001), MCH (p < 0,001), MCHC (p < 0,001), iron (p < 0,001), ferritin (p < 0.001) and hepcidin (p = 0.001) levels in Group I were found to be significantly lower. Besides, RDW value was significantly higher in the iron deficiency group compared to the control group (p=0.001). When Group I and Group II values were compared, significant increases were determined in erythrocyte count (p=0.034), hemoglobin, hematocrit, MCV (p<0.001 for each), MCHC (p=0.002), iron (p<0.001), ferritin (p=0.015) and hepcidin levels (p<0.001). A significant decrease was found in iron binding capacity after the treatment (p=0.004). In Group I, hepcidin levels had a significant and strong correlation with initial ferritin levels (r = 0.829, p < 0.001). When erythrocyte levels of Group I and Group II were compared, there was a decrease in the erythrocyte levels of Group II, but this decrease was not statistically significant. However, hepcidin levels displayed moderate or weak correlation with neutrophil count (r = -0.429, p = 0.037), eosinophil count (r = -0.447, p = 0.029) and iron level (r = 0.594, p = 0.002). Conclusion: In the study, a strong and positive correlation was determined between ferritin and hepcidin levels in individuals with iron deficiency. This may suggest that hepcidin is largely regulated by iron deposit level. In addition, following the iron treatment, an increase was found in ferritin and hepcidin levels. In the study, no significant difference was found between theiron deficiency group and the control group in terms of erythroferrone levels.