Ning Xiaojing, Peng Fei, Tan Siyu, Tang Cheng, Luo Chaotian, Xiao Fangyan, Zhao Chen, Peng Peng
Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
NHC Key Laboratory, Thalassemia Medicine (Guangxi Medical University), Nanning, Guangxi Zhuang Autonomous Region, China.
Expert Rev Hematol. 2024 Dec;17(12):977-983. doi: 10.1080/17474086.2024.2435353. Epub 2024 Dec 3.
In patients with thalassemia, different organs are affected differently by iron overload. Nevertheless, the reasons for this could be the same key transporters. This study investigated the iron deposition in different organs of transfusion-dependent thalassemia (TDT) patients and its correlation.
This cross-sectional study involved 54 TDT patients who underwent MRI T2* examinations of the heart, liver, pancreas, spleen, kidneys, and pituitary. The study analyzed the iron deposition in each organ and evaluated the correlation of iron deposition using Spearman's test.
Among the 54 patients with TDT, liver iron overload was found in 49/54 (90.7%) cases, pancreas iron overload in 43/54 (79.6%) cases, spleen iron overload in 18/26 (69.2%) patients, heart iron overload in 20/54 (37.0%) cases, and kidney iron overload in 8/54 (14.8%) patients. Most patients (66.7%) with iron overload in the liver but not in the heart exhibited spleen iron abnormalities. Pituitary T2* and pancreas T2* (r = 0.790), pituitary T2* and kidney T2* (r = 0.692), kidney T2* and pancreas T2* (r = 0.672) showed positive correlation (all p < 0.05).
Patients with TDT exhibited significant organ-specific iron overload. These findings highlight the importance of routine MRI screening for monitoring and managing iron overload in patients with TDT. Pituitary, pancreas, and kidney may have similar iron-loading mechanisms.
在地中海贫血患者中，不同器官受铁过载的影响不同。然而，其原因可能是相同的关键转运蛋白。本研究调查了输血依赖型地中海贫血（TDT）患者不同器官中的铁沉积情况及其相关性。
这项横断面研究纳入了54例接受心脏、肝脏、胰腺、脾脏、肾脏和垂体MRI T2*检查的TDT患者。该研究分析了每个器官中的铁沉积情况，并使用Spearman检验评估铁沉积的相关性。
在54例TDT患者中，49/54（90.7%）例出现肝脏铁过载，43/54（79.6%）例出现胰腺铁过载，18/26（69.2%）例患者出现脾脏铁过载，20/54（37.0%）例出现心脏铁过载，8/54（14.8%）例患者出现肾脏铁过载。大多数肝脏有铁过载但心脏没有铁过载的患者（66.7%）存在脾脏铁异常。垂体T2与胰腺T2（r = 0.790）、垂体T2与肾脏T2（r = 0.692）、肾脏T2与胰腺T2（r = 0.672）呈正相关（均p < 0.05）。
TDT患者表现出显著的器官特异性铁过载。这些发现凸显了常规MRI筛查在监测和管理TDT患者铁过载方面的重要性。垂体、胰腺和肾脏可能具有相似的铁负荷机制。
