Assessment of Iron Deficiency in Cyanotic Congenital Heart Diseases

Open Access

Abstract

Background: Cyanotic congenital heart diseases (CCHDs) are structural heart anomalies resulting in systemic hypoxemia. While secondary erythrocytosis is a compensatory response to chronic hypoxia, iron deficiency may complicate this adaptation, potentially exacerbating morbidity and reducing oxygen-carrying efficiency. Aim of the study: To evaluate the prevalence of iron deficiency in children with CCHD and to identify the diagnostic utility of basic hematologic parameters in comparison to definitive biochemical tests. Methods & Materials: This cross-sectional observational study included 20 children with CCHD who had not undergone corrective surgery. Participants were divided into two groups based on serum ferritin levels: iron-deficient (Group A) and iron-sufficient (Group B). Hematological parameters (Hb, PCV, MCV, MCH, MCHC, RDW, peripheral smear) and biochemical markers (serum iron, TIBC, transferrin saturation) were analyzed. Statistical analysis included Chi-square tests and logistic regression. Result: Iron deficiency was confirmed in 50% of participants based on serum ferritin and transferrin saturation. Strong correlations were found between iron deficiency and microcytic hypochromic indices. RDW emerged as the only independent hematologic predictor of iron deficiency (p = 0.04). Clinical features such as underweight status and male predominance were more common among iron-deficient children. Conclusion: Routine hematologic tests, especially RDW, can be useful screening tools for iron deficiency in CCHD patients when biochemical testing is unavailable. Early detection and intervention are crucial to prevent complications related to iron-deficient erythropoiesis.