Longitudinal changes in serum ferritin levels correlate with measures of hepatic stiffness in transfusion-independent patients with β-thalassemia intermedia.
Despite evidence of considerable iron overload in transfusion-independent patients with β-thalassemia intermedia, data on hepatic outcomes remain scarce. We analyzed data from a cohort of 42 β-thalassemia intermedia adults followed for four years (median age 38years), and evaluated the association between longitudinal changes in serum ferritin levels and transient elastography values, a measure of hepatic stiffness predictive of fibrosis. We observed a significant increase in both serum ferritin levels (+81.2 [μg/l]/year) and transient elastography values in non-chelated patients (n=28) (+0.3kPa/year), with two patients worsening their fibrosis stage. Chelated patients (n=14) had a significant decrease in both measures (-42.0 [μg/l]/year and -0.9kPa/year, respectively), with two patients improving their fibrosis stage. There was a strong correlation between the rate of change in serum ferritin level and the rate of change in transient elastography value (R(2): 0.836, p<0.001) noted in both non-chelated and chelated patients. An association between iron overload status and hepatic disease merits further evaluation in this subset of transfusion-independent patients.
Department of Medicine and Medical Specialties, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
Khaled M
KM
Musallam
Irene
I
Motta
Marta
M
Salvatori
Mirella
M
Fraquelli
Alessia
A
Marcon
Ali T
AT
Taher
Maria Domenica
MD
Cappellini
D000328:Adult; D001803:Blood Transfusion; D016022:Case-Control Studies; D054459:Elasticity Imaging Techniques; D005260:Female; D005293:Ferritins / Q000097:blood*; D005355:Fibrosis; D006801:Humans; D007501:Iron / Q000378:metabolism*; D007502:Iron Chelating Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019190:Iron Overload / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017086:beta-Thalassemia / Q000097:blood / Q000188:drug therapy / Q000473:pathology*
D007502:Iron Chelating Agents; D005293:Ferritins; D007501:Iron