Articles Vol. 65 No. 5 04/09/2024

34. CHARACTERISTICS OF IRON LOAD STATUS IN THALASSEMIA PATIENTS RECEIVING IRON TREATMENT AT SAINT PAUL GENERAL HOSPITAL

Luu Thi Chinh1,2
1 Hanoi University of Public Health
2 Trường Đại học Y tế công cộng
Corresponding author: ltc@huph.edu.vn
DOI: 10.52163/yhc.v65i5.1436
62 Views
20 Downloads
Keywords
Thalassemia iron overload liver iron concentration
Abstract

Objective: Describe iron overload in thalassemia patients treated with iron chelation at Saint Paul General Hospital.

Subjects: Include 46 thalassemia pediatric patients diagnosed and treated for iron overload at Saint Paul General Hospital from March 2023 to December 2023.

Research methods: Prospective study, describing a series of cases.

Results: The average age of the patients was 8.3 ± 3.56 years old, the 5-10 year old group had the highest rate (56.5%). The male ratio is 41.3%, female is 58.7%. The patient's serum ferritin concentration was high, with an average of 1818.99 ± 988.38 ng/ml. The group with moderate and severe ferritin accounts for 82.6%. 100% of patients have liver iron infection of all levels (mild to severe); the average liver iron concentration concentration was 11.06 ± 3.17 mg/g dry liver. There was a positive correlation with r = 0.627 between serum ferritin concentration and liver iron concentration. Severe liver iron infection in the serum ferritin ≥ 2500 ng/ml group was 21.875 times higher than the serum ferritin < 2500 ng/ml group, a significant difference with p < 0.05, OR = 21.875 and 95%CI = 3.147-152.048.

Conclusion: Iron overload is a consequence of blood transfusion, accumulating in organs causing serious complications. Measuring serum ferritin levels and magnetic resonance imaging measuring liver liver iron concentration index help evaluate and monitor the body's level of iron overload.

References
[1]
Taher AT, Weatherall DJ, Cappellini MD, Thalassaemia, The Lancet, 2018, 391 (10116), 155-167. doi:10.1016/S0140-6736 (17)31822-6 Google Scholar
[2]
Fibach E, Rachmilewitz EA, Pathophysiology and treatment of patients with beta thalassemia - an update, F1000Res, 2017, 6, doi: 10.12688/11000research.12688.1. Google Scholar
[3]
Cappellini MD, Cohen A, Porter J et al, Guidelines for the management of transfusion dependent thalassaemia (TDT), Thalassaemia International Federation Nicosia, Cyprus, 2014. Google Scholar
[4]
Silva B, Faustino P, An overview of molecular basis of iron metabolism regulation and the associated pathologies, Biochimica et Biophysica Acta, 2015, 1852 (7), 1347-59. Google Scholar
[5]
Ruefer A, Bapst C, Benz R et al, Role of liver magnetic resonance imaging in hyperfentinaemia and the diagnosis of iron overload. Swiss Medical Weekly, 2017, 147 (4546), doi: 10.4414/smw 2017.14550. Google Scholar
[6]
Koorts AM, Viljoen M, Ferritin and ferritin isoforms I: structure - function relationships, synthesis, degradation and secretion, Arch Physiol Biochem, 2007, 113, 30-54. Google Scholar
[7]
Fernandes JL, MRI for Iron Overload in thalassemia, Hematol Oncol Clin North Am, 2018, 32 (2), 277-295. Google Scholar
[8]
Labranche R, Gilbert G, Cerny M et al, Liver Iron Quantification with MR Imaging: A Primer for Radiologists, Radiographics, 2018, 38 (2), 392-412. Google Scholar
[9]
Di Maggio R, Maggio A, The new era of chelation treatments: effectiveness and safety of 10 different regimens for controlling iron overloading in thalassaemia major, Br J Haematol, 2017, 178 (5), 676-688. Google Scholar
[10]
Đào Thị Thiết, Nghiên cứu một số đặc điểm ứ sắt và kết quả điều trị thải sắt bằng Deferasirox ở bệnh nhân thalassemia tại Viện Huyết học - Truyền máu Trung ương, Published online, 2016. Google Scholar
[11]
Phạm Hồng Đức, Phạm Minh Thông, Trần Công Hoan và cộng sự (2013), Nghiên cứu mức độ ứ sắt trong gan trong bệnh thalassemia trên chụp cộng hưởng từ 1.5 Tesla, Tạp chí Y học thực hành, số 1, 62-65. Google Scholar
[12]
Nguyễn Thị Thu Hà, Nghiên cứu đặc điểm đột biến gen globin và theo dõi điều trị thải sắt ở bệnh nhân thalassemia tại Viện Huyết học - Truyền máu Trung ương giai đoạn 2013-2016, Luận án tiến sỹ y học, Trường Đại học Y Hà Nội, 2017. Google Scholar