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      Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children

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          Abstract

          CONTEXT:

          T2* magnetic resonance imaging (MRI) is being increasingly used for the assessment of organ iron content in thalassemics, but cost is a major prohibitive factor for repeated measurements. If serum ferritin correlates well with the T2* MRI liver and heart, it will be economical and more simple tool to assess organ iron deposition.

          AIMS:

          The aim of this study was to find out the relationship between serum ferritin level and T2* MRI-derived liver and heart iron content in transfusion-dependent thalassemic children

          SETTINGS:

          Thalassemia day-care center of a teaching hospital

          DESIGN:

          This was a cross-sectional study

          SUBJECTS AND METHODS:

          Seventy-three transfusion-dependent beta thalassemic children belonging to 2–18 years of age were subjected to T2* MRI of heart and liver to assess their iron content. Values obtained here were related to serum ferritin.

          STATISTICAL ANALYSIS USED:

          Keeping the correlation between serum ferritin and T2* MRI as primary outcome, spearman's correlation coefficient was calculated.

          RESULTS:

          We found poor (negative) correlation between serum ferritin level and T2* MRI liver ( r = -0.448, P = 0.000) but no correlation between serum ferritin and T2*MRI heart ( r = -0.221, P = 0.060).

          Conclusions:

          Serum ferritin cannot reliably predict the liver and heart iron content in Indian children with β thalassemia.

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          Most cited references19

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          Beta-thalassemia.

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            Magnetic resonance imaging measurement of iron overload.

            J. Wood (2007)
            To highlight recent advances in magnetic resonance imaging estimation of somatic iron overload. This review will discuss the need and principles of magnetic resonance imaging-based iron measurements, the validation of liver and cardiac iron measurements, and the key institutional requirements for implementation. Magnetic resonance imaging assessment of liver and cardiac iron has achieved critical levels of availability, utility, and validity to serve as the primary endpoint of clinical trials. Calibration curves for the magnetic resonance imaging parameters R2 and R2* (or their reciprocals, T2 and T2*) have been developed for the liver and the heart. Interscanner variability for these techniques has proven to be on the order of 5-7%. Magnetic resonance imaging assessment of tissue iron is becoming increasingly important in the management of transfusional iron load because it is noninvasive, relatively widely available and offers a window into presymptomatic organ dysfunction. The techniques are highly reproducible within and across machines and have been chemically validated in the liver and the heart. These techniques will become the standard of care as industry begins to support the acquisition and postprocessing software.
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              Iron chelators for the treatment of iron overload disease: relationship between structure, redox activity, and toxicity.

              The success of the iron (Fe) chelator desferrioxamine (DFO) in the treatment of beta-thalassemia is limited by its lack of bioavailability. The design and characterization of synthetic alternatives to DFO has attracted much scientific interest and has led to the discovery of orally active chelators that can remove pathological Fe deposits. However, chelators that access intracellular Fe pools can be toxic by either inhibiting Fe-containing enzymes or promoting Fe-mediated free radical damage. Interestingly, toxicity does not necessarily correlate with Fe-binding affinity or with chelation efficacy, suggesting that other factors may promote the cytopathic effects of chelators. In this review, we discuss the interactions of chelators and their Fe complexes with biomolecules that can lead to toxicity and tissue damage. Copyright 2003 Wiley-Liss, Inc.
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                Author and article information

                Journal
                Asian J Transfus Sci
                Asian J Transfus Sci
                AJTS
                Asian Journal of Transfusion Science
                Medknow Publications & Media Pvt Ltd (India )
                0973-6247
                1998-3565
                Jan-Jun 2018
                : 12
                : 1
                : 69-74
                Affiliations
                [1] Department of Pediatrics, Dr S N Medical College, Jodhpur, Rajasthan, India
                Author notes
                Address for correspondence: Dr, Vishnu Kumar Goyal, 4A2, Chopasni Housing Board, Jodhpur - 342 008, Rajasthan, India. E-mail: goyalvishnu@ 123456yahoo.com
                Article
                AJTS-12-69
                10.4103/ajts.AJTS_3_17
                5850701
                c98d2167-983d-47b3-96e9-e2403c306995
                Copyright: © 2018 Asian Journal of Transfusion Science

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 07 January 2017
                : 29 April 2017
                Categories
                Original Article

                Hematology
                hemolytic anemia,iron deposition,organ magnetic resonance imaging
                Hematology
                hemolytic anemia, iron deposition, organ magnetic resonance imaging

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