Abstract
Background Chelation therapy has been used to eliminate excess iron. The effective management of thalassemic patients, especially in the paediatric age group, requires optimal monitoring of the toxic effects of both iron overload and excessive chelation therapy. Serum ferritin has been widely used as a surrogate marker and a target ferritin level of 1,000 ng/ml is generally recommended.
Objectives Study of assessment of cardiac and hepatic iron overload in thalassemia syndrome cases
Methods This study was conducted in a tertiary care hospital where thalassemic patients receive regular transfusions. Patients aged 13–33 years coming for routine blood transfusions at the hospital blood bank and also out-patients coming for regular follow up and receiving transfusions at other blood transfusion centres between November 2011 and November 2012 were included in the study. A detailed history and physical examination were completed for all cases and the findings recorded on a proforma.
Results Out of 53 cases the average hepatic iron overload over a study period shows that 34% (18) cases have severe hepatic iron overload, 39.6% (21) cases have moderate hepatic iron overload, 17% (9) cases have mild hepatic iron overload and only 9.4% cases have normal hepatic iron status.
Conclusions Arterial stiffness increases significantly as cardiac iron overload increases but there is no correlation between arterial stiffness and hepatic iron overload. As stiffness index is an indirect measure of CIMT and early atherosclerosis, it also shows and indirect correlation of CIMT with increasing cardiac iron overload. Thus our findings support the hypothesis that iron overload is a risk factor for early atherosclerosis and cardiovascular disease.
