Hepatic iron overload: diagnosis and quantification with MR imaging.

Ernst, Olivier; Sergent, Géraldine; Bonvarlet, P; Canva-Delcambre, V.; Paris, J; L’Herminé, C

doi:10.2214/ajr.168.5.9129412

Cited by 127 publications

(86 citation statements)

References 14 publications

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“…16 It has also been reported that lower iron accumulation is better demonstrated in gradient echo sequences, whereas iron overload is better visualized in spin echo sequences. [17][18][19] In our case, the hepatic iron load was estimated to be 44±20 µmol/g (normal <36 µmol/g) in T 2 sequences, which is consistent with mild degrees of iron load.…”

Section: Discussionsupporting

confidence: 74%

Hemochromatosis Mistakenly Treated as Rheumatoid Arthritis

2014

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A 44-year-old female patient was admitted to our clinic with complaints of episodic pain, swelling attacks, and progressive deformity in both wrists and metacarpophalangeal joints lasting for five years. Based on her complaints, she had been diagnosed with rheumatoid arthritis and taken methotrexate, sulphasalazine, and prednisolone for two years, however, the patient had discontinued her treatment a year earlier due to ongoing symptoms. Physical examination revealed limited range of motion of both wrists and flexion deformity of the fingers without active inflammation signs. Hand X-ray showed typical signs of osteoarthritis characterized by narrowed joint spaces, subchondral sclerosis, and cyst formation. The distal and proximal interphalangeal joints were markedly preserved, and there were large, hook-like osteophytes in the heads of the metacarpal bones, indicating a typical presentation of hemochromatosis. Laboratory tests revealed that the erythrocyte sedimentation rate and C-reactive protein and uric acid levels were within the normal range, and the antibody tests were negative for rheumatoid factor, anti-nuclear antibodies, and anti-cyclic citrullinated peptides. Although the serum iron and ferritin levels were normal, there was a high transferrin saturation rate. Magnetic resonance imaging demonstrated a hepatic iron concentration of 44 µmol/g (reference: <36 µmol/g). Genetic studies showed homozygous for the H63D mutation. Based on these findings, the patient was diagnosed with hereditary hemochromatosis and scheduled for follow-up visits. In conclusion, hemochromatosis should be considered in the differential diagnosis in patients suffering from slow-progressing arthritis with chronic deformity.

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Section: Discussionsupporting

confidence: 74%

Hemochromatosis Mistakenly Treated as Rheumatoid Arthritis

2014

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“…A prior study [4] found that liver T2 values correlated with hepatic iron concentration and with serum ferritin. These and other studies [12] have established that MRI is a reliable and useful noninvasive tool for quantifying hepatic iron in iron overload states.…”

Section: Discussionmentioning

confidence: 75%

Respiratory function in patients with thalassaemia and iron overload

Dimopoulou¹,

Kremastinos²,

Maris³

et al. 1999

Eur Respir J

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Iron deposition in the respiratory system has been proposed as a potential cause of the ventilatory restrictive impairment seen in patients with thalassaemia major (TM) and iron overload. In this study, magnetic resonance imaging (MRI) measurements of the liver (T2 relaxation time) were used as a surrogate index of total body iron burden and the extent to which these measurements correlated with total lung capacity (TLC) in patients with TM was examined.Twenty-one patients (aged 255 yrs) with TM participated in the study. Standard pulmonary function tests were undertaken and the T2 relaxation time of the liver was measured in all patients.Ventilatory restrictive impairment (mean TLC 7411 (SD)% predicted) was the most common abnormality found in 71% of TM patients. There was no correlation between TLC (% pred) and T2 relaxation time (r=0.06, p=0.78). T2 relaxation time correlated weakly with average serum ferritin levels (r=-0.56, p=0.008).In conclusion, the data do not support the notion that the restrictive impairment in patients with thalassaemia major and iron overload is related to iron deposition in the respiratory system. Eur Respir J 1999; 13: 602±605.

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“…In patients with serum ferritin (above normal value), a quantitative measurement of LIC by T2* MRI using gradient echo sequences and signal intensity ratio was performed as previously described. 10 An evaluation of HFE (C282Y) status at pre-transplant on available frozen DNA was made. Exclusion criteria were: hepatitis C or active hepatitis B, alcoholism (at least one positive response according to CAGE questionnaire), patients continuing immunosuppressive therapy or hepatotoxic drug administration, patients with clinical GVH or prior histologically documented chronic graft versus host disease or veno-occlusive disease, patients with active documented bleeding requiring blood transfusion after the one year period following transplant, patients with inflammation (sedimentation rate of more than 30 and/or C Reactive Protein more than >5 mg/L), patients who developed a neoplastic disease or relapsed during the 21 month study period.…”

Section: Design and Methodsmentioning

confidence: 99%