Iron overload in Brazilian thalassemic patients

Assis, Reijane Alves de; Kay, Fernando Uliana; Rosemberg, Laércio Alberto; Parma, Alexandre; Nomura, César Higa; Loggetto, Sandra Regina; Araújo, Aderson da Silva; Fabron, Antonio; Veríssimo, Mônica Pinheiro de Almeida; Baldanzi, Giorgio Roberto; Steagal, Merula A.; Velloso, Claudia Angela Galleni Di Sessa; Espósito, Breno Pannia; Nakashima, Sandra Saemi; Diniz, Michelli da Silva; Tricta, Fernando; Baroni, Ronaldo Hueb; Funari, Marcelo Buarque de Gusmão; Wood, John C.; Ribeiro, Andreza Alice Feitosa; Hamerschlak, Nelson

doi:10.1590/s1679-45082011ao1897

Cited by 4 publications

(6 citation statements)

References 29 publications

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“…This is explained by the fact that both pancreas and cardiac iron overload share the same iron loading pathway. This finding is similar to other study findings (14,17,18,20,21). One large multicentric observational study indicated that pancreatic iron is a powerful predictor of not only glucose metabolic dysfunction but also the cardiac iron and its complication (22).…”

Section: Figuresupporting

confidence: 94%

Magnetic resonance imaging T2* of the pancreas value using an online software tool and correlate with T2* value of myocardium and liver among patients with transfusion-dependent thalassemia major

et al. 2022

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ObjectivePatients with thalassemia major do require lifetime blood transfusions that eventually result in iron accumulation in different organs. We described the usefulness of using magnetic resonance imaging (MRI) T2*imaging values for the evaluation of pancreatic iron load in these patients, and we correlated it with MRI T2* haemosiderosis of the myocardium and liver that has been recognized as a non-invasive assessment of iron overload among patients with thalassemia major.Materials and methodsWe conducted a cross-sectional study on 39 patients with thalassemia major in one of the tertiary university hospitals for a 1-year period. Demographic data were collected from the patient's history. MRI T2* of the pancreas, liver, and heart were executed on all patients in the same setting. Objective values of iron overload in these organs were obtained using the MRI post-processing software from online software.ResultsA total of 32 (82.1%) patients had pancreatic iron overload including 2 patients (5.1%) with severe iron overload and 15 patients (38.5%) with moderate and mild iron overload, respectively. Nine patients (23.1%) had myocardial iron overload, which included 3 patients (7.7%) who had severe cardiac haemosiderosis. Notably, 37 patients (94.9%) had liver iron overload, which included 15 patients (38.5%) who had severe liver haemosiderosis. There was a moderate positive correlation between the relaxation time of the pancreas and heart haemosiderosis (r = 0.504, P < 0.001). No significant correlation was found between the relaxation time of the pancreas with the liver and the heart with the liver.ConclusionPancreatic haemosiderosis precedes cardiac haemosiderosis, which establishes a basis for initiating earlier iron chelation therapy to patients with thalassemia major.

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Section: Figuresupporting

confidence: 94%

Magnetic resonance imaging T2* of the pancreas value using an online software tool and correlate with T2* value of myocardium and liver among patients with transfusion-dependent thalassemia major

et al. 2022

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“…These variable results could be because of differences in clinical, genetic, and demographic characteristics of study population such as age, sample size, serum ferritin levels, chelating protocols, and iron kinetics of different organs. Our study population was more homogenous with narrow age range (2–18 years) in comparison to previous studies[ 19 20 22 23 ] where age group ranged from as young as 5 years to as old as 54 years. Overall, our population was also quite younger than previous studies; mean age - 9.06 ± 4.64 years in our study versus 22.79 ± 7.1 and 22.77 ± 6.2 thalassemia major and intermedia groups, respectively, in Majd et al .,[ 16 ]21.25 years in Assis et al .,[ 23 ] 24.1 ± 5.4 years in Azarkeivan et al .,[ 19 ] and 25.59 ± 8.5 years in Zamani et al .…”

Section: Discussionmentioning

confidence: 65%

“…[ 22 ] showed moderate correlation, and in contrast to our study, Assis et al . [ 23 ] demonstrated excellent correlation between serum ferritin and T2* MRI liver.…”

Section: Discussionmentioning

confidence: 99%

“…However, we failed to correlate these two parameters and our results are consistent with the findings observed by Kolnagou et al .,[ 20 ] Assis et al . [ 23 ](both no correlation), and Anderson et al . [ 10 ]( r = 0·15, P = 0·11).…”

Section: Discussionmentioning

confidence: 99%

“…Mean serum ferritin level also varied from 1600 ± 1805 to 2676.5 ± 2051.7 ng/ml in previous studies. [ 23 21 ] Azarkeivan et al . [ 19 ] noted that serum ferritin level more than 4000 ng/ml weakens the correlation between serum ferritin and T2* MRI (liver and heart), the similar finding was observed by Worwood et al .…”

Section: Discussionmentioning

confidence: 99%

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Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children

Suthar

Goyal

Sharma

et al. 2018

Asian J Transfus Sci

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CONTEXT:T2* magnetic resonance imaging (MRI) is being increasingly used for the assessment of organ iron content in thalassemics, but cost is a major prohibitive factor for repeated measurements. If serum ferritin correlates well with the T2* MRI liver and heart, it will be economical and more simple tool to assess organ iron deposition.AIMS:The aim of this study was to find out the relationship between serum ferritin level and T2* MRI-derived liver and heart iron content in transfusion-dependent thalassemic childrenSETTINGS:Thalassemia day-care center of a teaching hospitalDESIGN:This was a cross-sectional studySUBJECTS AND METHODS:Seventy-three transfusion-dependent beta thalassemic children belonging to 2–18 years of age were subjected to T2* MRI of heart and liver to assess their iron content. Values obtained here were related to serum ferritin.STATISTICAL ANALYSIS USED:Keeping the correlation between serum ferritin and T2* MRI as primary outcome, spearman's correlation coefficient was calculated.RESULTS:We found poor (negative) correlation between serum ferritin level and T2* MRI liver (r = -0.448, P = 0.000) but no correlation between serum ferritin and T2*MRI heart (r = -0.221, P = 0.060).Conclusions:Serum ferritin cannot reliably predict the liver and heart iron content in Indian children with β thalassemia.

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Correlation of serum ferritin levels with hepatic MRI T2 and liver iron concentration in nontransfusion beta-thalassemia intermediate patients: A contemporary issue

Karimi

Amirmoezi

Haghpanah

et al. 2017

Pediatric Hematology and Oncology

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Iron overload in Brazilian thalassemic patients

Cited by 4 publications

References 29 publications

Magnetic resonance imaging T2* of the pancreas value using an online software tool and correlate with T2* value of myocardium and liver among patients with transfusion-dependent thalassemia major

Magnetic resonance imaging T2* of the pancreas value using an online software tool and correlate with T2* value of myocardium and liver among patients with transfusion-dependent thalassemia major

Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children

Correlation of serum ferritin levels with hepatic MRI T2 and liver iron concentration in nontransfusion beta-thalassemia intermediate patients: A contemporary issue

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