Iron Overload in Sickle Cell Disease

Table 1

Tests to estimate iron load.

TEST	Application
Serum ferritin	Relatively unreliable in SCD, especially in the range of 1500–3000 ng/mL. In this range, levels of ferritin do not linearly correlate with HIC
SQUID	Reliable predictor of HIC, but expensive and available in few institutions worldwide, mostly for research purposes
T2* MRI	Well-validated predictor of HIC and cardiac complications from iron overload
Liver biopsy	Gold standard. Accurate estimation of iron overload except in fibrosis. Invasive but <1% risk of complications. Sampling error possible