The inverse correlation between serum of anti-pneumococcal and ferritin levels after pneumococcal vaccination in splenectomised beta thalassemia major

Resumen

Splenectomy is necessary in beta thalassemia major (BTM) patients when the spleen develops hyperactive which leading to extreme destruction of erythrocytes. This study assessed the ferritin effect on serum pneumococcal antibody (APA) response following of pneumococcal vaccination in patients with BTM after splenectomy. In this case series study, convenience sampling was used to recruit 347 SBT patients under the auspices of Jahrom University of Medical Sciences. Demographic data such as age, sex, and time after splenectomy were recorded by a questionnaire. All participants have been splenectomised and received a dose of pneumococcal vaccine 14 days before surgery. The IgG antibody responses to pneumococcal vaccine and levels of serum specific ferritin were determine by commercial enzyme immunoassay kits. For the analysis, we used SPSS software version 16. A p-value less than 0.05 were considered statistically significant. More participants (63.4%) were hypo-responder to pneumococcal vaccine. Also, serum APA was related to Post splenectomy duration (PSD) and serum ferritin (p< 0.001) but not to gender (p> 0.05). An important result was a relation of serum APA to serum ferritin according to PSD groups. Therefore, in three groups of PSD, the serum ferritin was higher in hypo-responder than in good responder subjects.  Our results indicate that serum anti-pneumococcal IgG antibody decreased with increment of serum ferritin and PSD. Thus, there is a need to re-address the approach towards revaccination in this immune-compromised group of patients by administering a booster pneumococcal vaccination in an attempt to recover immunity and reduce morbidity.