Prevalence and Significance of Pancreatic Iron in Transfusion-Dependent Sickle Cell Disease

Pediatr Blood Cancer. 2025 Aug;72(8):e31780. doi: 10.1002/pbc.31780. Epub 2025 May 12.

Abstract

Background: Chronically transfused patients with sickle cell disease (SCD) and beta thalassemia major (TM) develop iron overload.

Objective: Determine the impact of iron overload on glucose regulation in SCD.

Methods: Prospective study of 28 patients with SCD and 38 patients with TM who underwent liver and pancreas R2* measurements and oral glucose tolerance tests.

Results: Impaired fasting glucose (2 vs. 9, p = 0.27) and impaired glucose tolerance (1 vs. 11, p = 0.019) were less common in patients with SCD compared with patients with TM. No SCD patient had diabetes.

Conclusion: Iron-mediated glucose dysregulation is present but less common in SCD patients.

Keywords: pancreatic siderosis; sickle cell disease; transfusion dependent.

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Sickle Cell* / complications
  • Anemia, Sickle Cell* / metabolism
  • Anemia, Sickle Cell* / therapy
  • Blood Glucose / metabolism
  • Blood Transfusion
  • Child
  • Child, Preschool
  • Female
  • Glucose Tolerance Test
  • Humans
  • Iron Overload* / epidemiology
  • Iron Overload* / etiology
  • Iron Overload* / metabolism
  • Iron* / metabolism
  • Male
  • Pancreas* / metabolism
  • Prevalence
  • Prospective Studies
  • Transfusion Reaction*
  • Young Adult
  • beta-Thalassemia* / complications
  • beta-Thalassemia* / metabolism
  • beta-Thalassemia* / therapy

Substances

  • Iron
  • Blood Glucose