title: Comparative study of radiographic and laboratory findings between Beta thalassemia major and Beta thalassemia intermedia patients with and without treatment by hydroxyurea.
abstract: BACKGROUND
  In patients with thalassemia, chronic anemia causes bone marrow expansion and consequently skeletal manifestation in spine, skull, face and rib bones.
  
  
  OBJECTIVE
  We aimed to compare chest radiographic findings and facial bone deformity in patients with thalassemia major (TM) and intermedia.
  
  
  METHODS
  In this cross sectional study, 86 consecutive thalassemia patients referring to the Thalassemia clinic in Shiraz, Southern Iran were evaluated during 2012. Patients were divided into three groups including TM and thalassemia intermedia (TI) with and without taking hydroxyurea (HU). Findings ofchest radiography (trabeculation, rib widening and paraspinal masses) as well as facial bone deformity were evaluated by an expert radiologist. Besides, laboratory findings were measured regarding hemoglobin, ferritin, NRBC and platelet count.
  
  
  RESULTS
  All radiologic findings were significantly higher in patients with TI compared to TM (P< 0.05). In patients with TI, only trabeculation was observed with a higher frequency in patients with HU compared to those without HU (68% vs. 27.3%, P= 0.008). In the regression model, from all variables evaluated, only NRBC showed a significant correlation with trabeculation (Exp B = 1.014, CI: 1.004-1.025, P = 0.008) and age showed a significant correlation with paravertebral mass (Exp B = 1.147, CI: 1.03-1.27, P = 0.013).
  
  
  CONCLUSIONS
  In patients with TM, bone widening, trabeculation, paraspinal masses and facial bone deformity were lower than patients with TI, whichcan be related to effectiveness of therapy with blood transfusion irrespective of its adverse effects in TM patients.
authors.affiliation: Medical Imaging Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Abolhasani Foroughi
authors.affiliation: Medical Imaging Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Hosein
authors.initials: H
authors.lastname: Ghaffari
authors.affiliation: Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Sezaneh
authors.initials: S
authors.lastname: Haghpanah
authors.affiliation: Department of Neurology, Motahhari Clinic, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Masoume
authors.initials: M
authors.lastname: Nazeri
authors.affiliation: Department of Pediatric, Urmia University of Medical Sciences, Urmia, IR Iran.
authors.forename: Roghieh
authors.initials: R
authors.lastname: Ghaffari
authors.affiliation: Department of Library and Information Science, College of Humanities, Khouzestan Science and Research Branch, Islamic Azad University, Ahvaz, IR Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Bardestani
authors.affiliation: Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Karimi
keywords: Beta-Thalassemia; Hydroxyurea; Mass Chest X-Ray
references.citation: Br J Radiol. 1999 Sep;72 (861):906-10
references.pmid: 10645201
references.citation: Biomed Res Int. 2014;2014:174581
references.pmid: 25110660
references.citation: Pediatr Hematol Oncol. 2009 Nov;26(8):560-5
references.pmid: 19954365
references.citation: Ann Hematol. 2004 Jul;83(7):430-3
references.pmid: 14722738
references.citation: Clin Radiol. 1979 Sep;30(5):521-4
references.pmid: 466956
references.citation: J Postgrad Med. 2005 Jan-Mar;51(1):45-6
references.pmid: 15793340
references.citation: Br J Haematol. 2007 Aug;138(3):291-304
references.pmid: 17565568
references.citation: Iran Red Crescent Med J. 2014 Jun;16(6):e18028
references.pmid: 25068055
references.citation: J Pediatr Hematol Oncol. 2011 Jul;33(5):339-43
references.pmid: 21602718
references.citation: Arch Iran Med. 2009 May;12(3):295-7
references.pmid: 19400608
references.citation: Minerva Med. 1982 Mar 3;73(9):457-66
references.pmid: 7063136
references.citation: Clin Chim Acta. 2009 Sep;407(1-2):10-5
references.pmid: 19545554
references.citation: Can Assoc Radiol J. 1991 Aug;42(4):278-82
references.pmid: 1884260
references.citation: Am Fam Physician. 2009 Aug 15;80(4):339-44
references.pmid: 19678601
references.citation: Indian Pediatr. 2007 Jan;44(1):29-32
references.pmid: 17277428
references.citation: Hemoglobin. 2009;33 Suppl 1:S177-82
references.pmid: 20001623
references.citation: Hematology. 2015 Jan;20(1):53-7
references.pmid: 24717020
references.citation: Ann Hematol. 2002 Aug;81(8):478-82
references.pmid: 12224008
references.citation: Br J Haematol. 1998 Dec;103(4):911-5
references.pmid: 9886300
references.citation: Am J Hematol. 1999 Dec;62(4):221-7
references.pmid: 10589077
references.citation: J Pediatr Hematol Oncol. 2009 Sep;31(9):681-3
references.pmid: 19687759
references.citation: Pediatr Hematol Oncol. 2014 Oct;31(7):583-96
references.pmid: 25247665
references.citation: Am J Hematol. 2008 May;83(5):366-70
references.pmid: 18181203
references.citation: Int J Lab Hematol. 2008 Oct;30(5):425-31
references.pmid: 19046318
references.citation: Eur Radiol. 1999;9(9):1804-9
references.pmid: 10602954
references.citation: Eur Spine J. 2010 Jun;19(6):871-8
references.pmid: 20204423
references.citation: J Blood Med. 2012;3:119-29
references.pmid: 23112580