The cellular and humoral immunities in patients with iron deficiency anemia

Aim It has been understood that iron is important for ensuring the continuity of immunity by determining the growth stimulator effect for immune cells, cytokine activity and cell-mediated immune effector pathways. We aimed to evaluate the cellular and humoral immunities in iron deficiency anemia (IDA) in this study. Material and Method Seventy patients (68 female and 2 male with mean age 36 ± 13 years) with IDA (hemoglobin levels less than 11 g/dl in female and 12 g/dl in male, serum ferritin level less than 16 ng/ml, and iron saturation below 15%) were enrolled to this study. 30 healthy subjects were accepted as the control group (28 women and 2 men with mean age 29 ± 9 years) without anemia, cancer, and hematologic malignancies, chronic infections and inflammatory diseases, diabetes mellitus and endocrine diseases, acute blood loss, chronic liver disease, chronic kidney disease, chronic alcoholism, pregnancy and regularly mineral/vitamin-supplemented. In both groups complete blood count, lymphocyte subgroups (CD3, CD4, CD5, CD8, and CD19 expression, CD4/CD8 ratio) by flow cytometric method cytokines by ELISA (IL-2, IL4, IL6), with turbidimetry method immunoglobulins (IgG, IgA, IgM) and complement levels (C3 and C4) were analyzed. Student's t-test was used for the comparison of numerical data in the patient and control groups by SPSS 15.0 for Windows. p value of <0.05 was considered as statistically significant. Results The expressions of CD3, CD4, CD5, CD19, and CD8 with CD4/CD8 ratios in lymphocytes, the levels of interleukin (IL-2, IL-4, IL-6), complement (C3, C4) and IgG and IgM were not significantly different between in two groups (p> 0.05). IgA levels in patients with IDA were significantly higher than those of control group (p = 0.004). Conclusion The cellular and humoral immunities were not affected in patients with IDA. High IgA levels should be a warning for Celiac disease in patients with IDA. Moreover it should be kept in mind that IDA is not a disease by itself and even patients are asymptomatic, endosocpic examination of gastrointestinal system for blood loss and gynecological evaluation in premenopausal women must be performed.