Correlation of Serum Ferritin with Hepatic Iron Overload among Nontransfusion Dependent Beta Thalassaemia with Haemoglobin E Disease Patients from Eastern India

Abstract

Introduction: Iron over load estimation was attempted by MRI R2* and serum ferritin, in non -transfusion dependent HbE Beta Thalassaemia patients. Methods: Seventy three patients selected on definite criteria were scanned and tested. Average age of the patients was 20.8 ± 11.14 years, 33 females and 40 male. Average hepatic iron concentration was determined to be 11.09 ± 11.74 mg/g of dry liver tissue and average serum ferritin was 972.44 ± 1121.51 ng/ml. Results: 81% of the patients had hepatic iron concentration more than 2 mg/g of dry liver tissue, whereas only 41% had serum ferritin level >500 ng/ml, irrespective of age. The hepatic iron overload pattern was heterogenous, where age and sex were not well determined variable predictors of such iron overload. Though, higher hepatic iron load was seen more predictably in patients above the age of 10 years and LIC of 5 mg/g of dry tissue correlated with serum ferritin level of approximately 400 ng/ml. Conclusion: It can be concluded that non transfusion dependence does not ensure non iron overload status and such patients should be scanned by using MRI R2* sequence to determine their hepatic iron status and start on excess iron chelation therapy if felt required.