A study of serum ferritin, alanine transaminase and hepatic MRI T2 values in beta-thalassemia major patients

Abstract

Background: Present transfusion protocols have increased life expectancy of patients with β-thalassemia. Non-invasive T2* MRI is a newer technique in developing countries with promising role in management of thalassemia. Our goal was to assess the hepatic dysfunction in multi-transfused thalassemia patients by estimating iron overload using hepatic MRI T2* values, and correlating the results with serum ferritin and serum alanine transaminase (ALT) values. Methods: This was a cross-sectional study of regularly transfused thalassaemia major patients from Thalassemia Center of Chacha Nehru Bal Chikitsalaya, M. Y. Hospital, a referral thalassaemia centre in Indore, Madhya Pradesh, India. The study was approved by the ethics committee of MGM Medical College, Indore, India. The study was conducted between August 2011 and September 2012. β-thalassaemia major patients who were regularly transfused and between the age of 5 to 15 years, were included. Results: It was fo und that thirty three percent of the patients had hepatic MRI T2* values less than 6.3ms. Serum ALT levels were found to be above three times the normal range in 88% of patients. Significant liver iron deposition starts occurring at an early age leading to liver dysfunction. Serum ferritin levels did not linearly correlate with liver iron load thus it may not be a reliable marker for monitoring of chelation therapy. Conclusions: For better management of thalassaemia patients, hepatic MRI T2* is suggested, instead of relying solely on serum ferritin.