Demonstration of iron in exfoliated buccal cells of β-thalassemia major patients

Abstract

Background:Thalassemia is a genetic disorder of hemoglobin synthesis, which requires regular blood transfusion therapy leading to iron overload in the body tissues. Transfusional hemosiderosis is a major cause of morbidity and mortality in these patients. Reliable methods for evaluation of iron overload are either invasive, costly or remotely available. Therefore, a simple technique of monitoring iron overload is desirable.Aim:To know whether iron can be demonstrated in exfoliated buccal cells of β-thalassemia major patients using Perls’ Prussian blue method and to correlate it with serum ferritin levels.Materials and Methods:Smears were obtained from buccal mucosa of 60 randomly selected β-thalassemia major patients and 30 healthy subjects as controls. Smears were stained with Perls’ Prussian blue method. Blood samples were taken for estimation of serum ferritin levels.Statistical Analysis:Chi-square, Mann-Whitney, and Spearman Rank's Correlation tests.Results:Perls’ positivity was observed in 71.7% of thalassemic patients with a moderately positive correlation to serum ferritin levels.Conclusion:Oral exfoliative cytology can be a useful tool in demonstration of iron overload in thalassemic patients, however, further research in this field in the direction of quantification of these procedures is required, which can establish this non-invasive procedure as an ideal screening tool.

Estimation of iron overloads using oral exfoliative cytology in beta-thalassemia major patients

“…Study by Bhat et al ., also showed positivity for iron granules in 43 out of 60 beta-thalassemia major patients. [ 9 ] The control group were negative for the Perls’ Prussian blue reaction in all the above-mentioned studies which were in accordance to our study.…”

Reducing the iron burden and improving survival in transfusion-dependent thalassemia patients: current perspectives

“…These results were considered significant, however, further research is required to support these findings. 14 …”

Comparative Study of the Endocrine Disorders of Βeta-Thalassemia Major Patients and Control Group in Duhok Province

“…Blood transfusion and iron chelation therapy have improved the quality of life and life-span to an around 30 years (Telfer et al,2009). Unfortunately repeated blood transfusions and increased gastrointestinal iron absorption lead to progressive iron overload in patients with β-thalassemia major disease (Bhat et al,2013).The progressive iron overload causes ineffective erythropoiesis, gastrointestinal absorption of iron and lack of physiologic mechanism for excreting the excess iron which results in hemochromatosis (Sagare and Trivedi, 2014).Iron deposits as hemosiderin and ferritin in the liver, spleen and many glands. Ferritin is used as a indicator for iron overload disorders (Chirico et al, 2015).…”