THE ASSOCIATION BETWEEN FERRITIN LEVELS AND INFECTION IN PATIENTS WITH β-THALASSEMIA : A LITERATURE REVIEW
DOI:
https://doi.org/10.31004/jkt.v6i4.53871Keywords:
β-thalassemia, disfungsi imun, ferritin, infeksi, penumpukan zat besiAbstract
Transfusi darah kronis pada pasien β-thalassemia sering kali menyebabkan penumpukan zat besi (iron overload) yang secara klinis umumnya tercermin dari meningkatnya ferritin serum sebagai penanda cadangan besi tubuh. Selain merefleksikan beban besi, peningkatan ferritin juga dapat mencerminkan proses patologis yang berkontribusi terhadap peningkatan kerentanan terhadap infeksi. Tinjauan literatur naratif ini bertujuan untuk menganalisis bukti ilmiah terkini (2020–2025) mengenai hubungan kadar ferritin tinggi/iron overload dengan kerentanan risiko infeksi pada pasien β-thalassemia serta mekanisme yang mendasarinya. Pencarian dilakukan melalui PubMed (via NCBI) dan Google Scholar, lalu disintesis secara naratif berdasarkan relevansi dan kualitas temuan. Hasil kajian menunjukkan bahwa ferritin tinggi berasosiasi dengan peningkatan kejadian dan kerentanan infeksi, terutama pada iron overload berat, berasosiasi dengan peningkatan kejadian infeksi seperti pneumonia, infeksi bakteri Gram-negatif, dan sepsis. Temuan mekanistik mengindikasikan disfungsi imun bawaan dan adaptif (gangguan neutrofil, perubahan subset monosit, serta perubahan profil sel NK pada kondisi tertentu seperti pasca splenektomi), disbiosis mikrobiota usus dan perubahan metabolit, serta disfungsi organ seperti gangguan hati, gangguan jantung dan disfungsi tubulus ginjal. Secara keseluruhan, kadar ferritin tinggi berpotensi meningkatkan risiko infeksi pada pasien β-thalassemia melalui kombinasi multifaktorial seperti ketersediaan besi bagi bakteri siderofilik, disbiosis mikrobiota, gangguan respons imun, dan disfungsi organ, namun interpretasinya perlu mempertimbangkan status inflamasi dan komorbid.References
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