Relationship between serum ferritin and hemoglobin levels determined by cardiac and hepatic T2 MRI in beta-thalassemia intermedia and major patients

Abstract

BACKGROUND: Thalassemia major is one of the most common hereditary disorders, and it causes ineffective hematopoiesis in the body through disarrangement of the hemoglobin synthesis balance. Regular blood transfusions cause complications of iron overload in the body in these patients. Tissue iron status can be determined by measuring serum and liver biopsy ferritin levels and by T2* MRI. This study assessed the relationship between serum ferritin and hemoglobin by T2* MRI of the heart and liver.

METHOD: This cross-sectional descriptive study was carried out on patients with beta-thalassemia intermedia and major who visited the Center for Thalassemia and Hemoglobinopathies at Shafa Hospital, Ahwaz, between 2014 and 2015. All patients were receiving regular blood transfusions every 2‒4 weeks. Pearson’s correlation test was used to assess serum ferritin and T2* values from heart and liver MRI.

RESULTS:A total of 260 patients (mean age is 23-year-old) were enrolled in the study. The incidence of iron overload in the liver and heart was 83% and 39%, respectively. Serum ferritin levels showed a very strong inverse correlation with T2* values on heart (r= -3.54, p<0.0001) and liver (r= -3.03, p<0.0001) MRI. Additionally, a meaningful interaction was observed between the T2* values from liver and heart MRI (r= 0.29, p<0.0001).

CONCLUSION:Serum ferritin is strongly and inversely correlated with T2* values of MRI of the liver and heart in patients with thalassemia. Therefore, T2* MRI can be used to assess tissue iron levels with very high accuracy.

Keywords

Serum ferritin / thalassemia / T2* MRI / liver / heart / iron overload

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