Serum Ferritin Levels and Irregular Use of Iron Chelators Predict Liver Iron Load in Patients With Major Beta Thalassemia: A Cross-Sectional Study Publisher Pubmed



Sobhani S¹ ; Rahmani F^{1, 2} ; Rahmani M¹ ; Askari M³ ; Kompani F³ Show Affiliations
Source: Croatian Medical Journal Published:2019

Abstract

Aim To determine whether serum ferritin, liver transaminases, and regularity and type of iron chelation protocol can be used to predict liver iron load as assessed by T2∗magnetic resonance imaging (MRI) in patients with beta thalassemia major (TM). Methods This cross-sectional study, conducted from March 1, 2014 to March 1, 2015, involved 90 patients with beta TM on regular packed red blood cell transfusion. Liver and cardiac iron load were evaluated with T2∗MRI. Compliance with iron-chelating agents, deferoxamine or deferasirox, and regularity of their use, as well as serum ferritin and liver transaminase levels were assessed. Results Patients with high serum ferritin were 2.068 times (95% confidence interval 1.26-3.37) more likely to have higher liver or cardiac iron load. High serum aspartate aminotransferases and irregular use of iron chelating agents, but not their type, predicted higher cardiac iron load. In a multiple regression model, serum ferritin level was the only significant predictor of liver and myocardial iron load. Conclusions Higher serum ferritin strongly predicted the severity of cardiac and liver iron load. Irregular use of chelator drugs was associated with a higher risk of cardiac and liver iron load, regardless of the type of chelating agent. © 2019 Medicinska Naklada Zagreb. All rights reserved.