Introduction: Inflammatory states are associated with anemia of chronic disease and acute infection. Hepcidin, the main regulator of iron metabolism, is involved in iron pathophysiology during inflammation. Our study aims to investigate the biochemical characteristics in different types of anemia in children.
Patients and Methods: Patients with anemia treated at Emek Medical Center were studied and divided, by etiology, into 4 groups: 1- inflammatory bowel disease (IBD); 2-celiac disease (CD); 3- iron deficiency (IDA); 4-acute infection (AI). Laboratory measurements evaluated at diagnosis, including complete blood count, serum iron, ferritin, transferrin, vitamin B12 and folic acid, CRP, erythropoietin (EPO) and hepcidin.
Results: 38 patients were included (IBD: 10; IDA: 12; CD: 8; AI: 8); mean age 12.44±4.35 (5–20) years. Several differences were found between the anemia groups: IDA-group showed the lowest values for Hb (6.9±1.7 gr/dL), MCV (63.2±7.2 fL), iron (16.8±13.5 ug/dL), ferritin (4.5±4.5 ng/mL) and hepcidin (3.1±0.8 ng/ml). While RDW (17.7±1.92%), transferrin (355.5±22.9 mg/dL) and EPO (311.2±254.9 mlu/ml) levels were the highest. AI-group showed the highest ferritin (156.2±124.5 ng/mL), CRP (144.6±94 mg/L) and hepcidin (74.67±12.3 ng/ml) levels. The Hepcidin levels correlated with CRP and ferritin values (r=0.83; 0.85).
Conclusions: In this study, we observed specific biochemical profile in pediatric anemic patients related to their etiologies. The combination of laboratory biomarkers including hepcidin can help physicians in the pathophysiological understanding, diagnosis and treatment of different types of anemia.
