Subject Area


Article Type

Original Study


Objectives: To investigate the significance of erythroferrone and hepcidin in β-thalassemia patients in prediction of frequency of transfusions, iron overload, and its impact on comorbidity and disease severity. Background: Repeated transfusions are used to treat anemia, the main concern of β-thalassemia patients. They cause iron to accumulate, which, if left untreated, results in significant morbidity. Erythroferrone (ERFE) was found to alter hepcidin release, thus increasing iron availability. This study investigated its usefulness as a predictor of iron overload status and its impact on severity and prognosis. Methods: A case-control study was done on 90 subjects, divided into two groups: Group A: patients’ group included 60 β thalassemia patients, further classified according to serum ferritin level at cutoff 2000.8 ng/ml into groups A1 and A2, and Group B: 30 apparently healthy controls. A thorough clinical examination, CBC, liver functions, kidney functions, serum iron, ferritin, and TIBC were performed. Serum levels of hepcidin and erythroferrone were assayed by ELISA. Results: There are significantly higher hepcidin and erythroferrone levels in groups A1 and A2 than in group B. Serum erythroferrone increased in groups A1 and A2 suffering from myocardial dysfunction, diabetes mellitus, and GB stones, and in patients with hepatomegaly in group A1. There is a negative correlation between erythroferrone and frequency of blood transfusions in groups A1 and A2. A positive correlation is found between frequency of blood transfusions and hepcidin in group A1 and serum iron in group A2. Conclusion: Erythroferrone can be an efficient biomarker of iron overload state, disease severity, and comorbidities better than hepcidin. It can also be used to predict the frequency of blood transfusions in β-TM patients.