The liver injury in patients with B-thalassemia major secondary to iron over load in Thalassemia center of Diwaniyah maternity and children teaching Hospital . A clinical study in Thalassemia center of Diwaniyah maternity and children teaching Hospital

Abstract

Background:
liver iron concentration assessed by MRI T2* is the better indicator of total-body iron depositions and should be checked in frequent blood transfused patients. MRI T2* can be detect iron overload before iron toxicity becomes clinically apparent.
Aim of study: to prevalence of liver injury among patients with B- thalassemia major secondary to iron over load in Thalassemia center of Diwaniyah maternity and children teaching Hospital.
Methods: This a cross – sectional study was carried out on 58 patients (34 males and 24 females ) diagnosed ?-thalassemia major on the base of the blood investigations (peripheral blood counts and hemoglobin electrophoresis), their age range from 9 years to 36 years. The study was conducted in Thalassemia center of Diwaniyah maternity and children teaching hospital in Al- Diwaniyah Governorate, Republic of Iraq. The Data collection was carried out during the period from the 30th of December 2015 to 11th of August 2016. They were studied for prevalence of liver injury among patients with thalassemia major secondary to iron over load. Results: Total numbers of B- thalassemia major patients are 58 patient. The numbers of patients with ages less than 10 years are 3 (5.2%), patients with ages(10-18)years are 39 (67.2%), patients with ages(19-25)years are 12(20.7%). statistically significant correlation was found between liver function test (LFT) abnormality ( ALT, AST) and numbers of blood transfusion per year (P=0.001) and also LFT abnormality ( ALT, AST) and ferritin levels (P=0.01). In our study reported that liver iron concentration was presented normal in 23 patients (39.7%), mild iron concentration in 29 patients (50.0%) and moderate iron concentration in 6 patients (10.3%). There was a significant association between serum ferritin level and the liver iron concentration assess by liver MRI T2* (P=0.002).
Conclusion: These results showed that correlation between ferritin, LFT abnormality and liver iron storage detected by MRI T2 in patients with ?-thalassemia major. MRI T2* has become the clinical standard to estimate liver iron overload.