Magnetic resonance imaging evaluation of the pituitary gland and hypothalamus in thalassaemic children with elevated serum ferritin levels.
OBJECTIVE
Despite modern treatment with hypertransfusion and chelation therapy, growth retardation continues to be observed in a significant proportion of thalassaemic children. The underlying reason remains unclear, but hypothalamic-pituitary axis disorder has been implicated. We aimed to assess iron overloading in the hypothalamus and pituitary gland in thalassaemic children with elevated serum ferritin, with and without growth retardation.


METHODS
Twelve thalassaemic children on hypertransfusion and chelation therapy with high serum ferritin were investigated with magnetic resonance imaging (MRI). Five children, all over 10 years of age, had growth retardation. Gradient recalled echo sequence was used to highlight any susceptibility effect that could be due to iron in the hypothalamus or pituitary gland.


RESULTS
There was no evidence of abnormal hypointense signal in the hypothalamus or pituitary gland in the patients studied, regardless of the presence of growth retardation.


CONCLUSIONS
There was no apparent characteristic MRI appearances of iron deposition in the hypothalamus or pituitary gland in thalassaemic children with high serum ferritin.
Department of Paediatrics, Prince of Wales Hospital, Hong Kong.
K Y
KY
Lau
Y L
YL
Chan
W W
WW
Lam
C K
CK
Li
C
C
Metreweli
D000293:Adolescent; D000328:Adult; D002614:Chelating Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005293:Ferritins / Q000097:blood*; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007031:Hypothalamus / Q000473:pathology*; D019190:Iron Overload / Q000097:blood / Q000209:etiology* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010902:Pituitary Gland / Q000473:pathology*; D065227:Transfusion Reaction; D017086:beta-Thalassemia / Q000150:complications* / Q000628:therapy
D002614:Chelating Agents; D005293:Ferritins