Raief Mosaad Basant Mohamed, Ibrahim Ahmed Samir, Mansour Mohamed G, ElAlfy Mohsen Saleh, Ebeid Fatma Soliman Elsayed, Abdeldayem Emad H
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Insights Imaging. 2022 Sep 4;13(1):140. doi: 10.1186/s13244-022-01280-x.
Pancreatic reserve could be preserved by early assessment of pancreatic iron overload among transfusion-dependent sickle cell disease (SCD) patients. This study aimed to measure pancreatic iron load and correlate its value with patients' laboratory and radiological markers of iron overload.
Sixty-six SCD children and young adults underwent MRI T2* relaxometry using a simple mathematical spreadsheet and laboratory assessment.
The results indicated moderate-to-severe hepatic iron overload among 65.2% of studied cases. None had cardiac iron overload. Normal-to-mild iron overload was present in the pancreas in 86% of cases, and 50% had elevated serum ferritin > 2500 ug/L. There was no significant correlation between pancreatic R2* level, serum ferritin, and hepatic iron overload. Patients with higher levels of hemolysis markers and lower pre-transfusion hemoglobin levels showed moderate-to-severe pancreatic iron overload.
Chronically transfused patients with SCD have a high frequency of iron overload complications including pancreatic iron deposition, thereby necessitating proper monitoring of the body's overall iron balance as well as detection of extrahepatic iron depositions.
通过对依赖输血的镰状细胞病（SCD）患者的胰腺铁过载进行早期评估，可保留胰腺储备功能。本研究旨在测量胰腺铁负荷，并将其值与患者铁过载的实验室和影像学标志物相关联。
66名SCD儿童和青年使用简单的数学电子表格和实验室评估进行了MRI T2* 弛豫测量。
结果表明，65.2% 的研究病例存在中度至重度肝脏铁过载。无一例有心脏铁过载。86% 的病例胰腺存在正常至轻度铁过载，50% 的患者血清铁蛋白升高 > 2500 μg/L。胰腺R2* 水平、血清铁蛋白和肝脏铁过载之间无显著相关性。溶血标志物水平较高且输血前血红蛋白水平较低的患者表现出中度至重度胰腺铁过载。
长期输血的SCD患者铁过载并发症的发生率很高，包括胰腺铁沉积，因此有必要对身体的整体铁平衡进行适当监测，并检测肝外铁沉积。
