title: Assessment of iron overload in very young children with limited thalassemia care resources in South China.
abstract: Southern China has one of the world's largest population of patients needing transfusions. Transfusion and chelation are not uniformly available and no magnetic resonance imaging (MRI) assessment data exists to date. A total of 153 young β-thalassemia major (β-TM) patients were assessed using a validated 1.5T scanner in Hong Kong, People's Republic of China (PRC). Their median age was 13 (range 7 to 30), and most patients were young (22.0% age <10, 73.0% age <15, 88.0% age <18). Erratic health care made estimation of total transfusion and chelation exposure impossible. Despite their early age, 24.0% had severe cardiac hemosiderosis [T2*<10 milliseconds (ms)], at ages as early as 8 years old. Median heart iron was 1.68 mg/g dry weight (range 0.19-7.66) and increased with age (p = 0.017), while liver iron was 22.2 mg/g dry weight (range 3.15 to 39.2). Serum ferritin levels were poor predictors of heart and liver, or pancreatic R* and pituitary R* values. Magnetic resonance imaging scans are needed to screen very young β-TM patients with immediate risk of premature cardiac death in developing nations and triage them to more intensive treatment. This is particularly important in countries with a large number of patients and limited resources. Our data suggests that in developing countries, there is no lower limit for thalassemia MRI scanning programs.
authors: Blood-Med Clinic , Hong Kong , People's Republic of China.
authors: Wing-Yan
authors: WY
authors: Au
authors: Chun Fu
authors: CF
authors: Li
authors: Jian Pei
authors: JP
authors: Fang
authors: Guang Fu
authors: GF
authors: Chen
authors: Xin
authors: X
authors: Sun
authors: Chang Gang
authors: CG
authors: Li
authors: Xin Hua
authors: XH
authors: Zhang
authors: Xue Dong
authors: XD
authors: Wu
authors: Hong Ying
authors: HY
authors: Gao
authors: Wen Ge
authors: WG
authors: Hao
authors: Darshana
authors: D
authors: Rasalkar
authors: Min
authors: M
authors: Deng
authors: Sio Peng A
authors: SP
authors: Mok
authors: Fernando
authors: F
authors: Tricta
authors: Winnie C W
authors: WC
authors: Chu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002681:China / Q000453:epidemiology; D005293:Ferritins / Q000097:blood; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology; D006486:Hemosiderosis / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D019190:Iron Overload / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D020380:Needs Assessment / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000592:standards*; D055815:Young Adult; D017086:beta-Thalassemia / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy
chemical_list: D005293:Ferritins