جستجوی مقالات مرتبط با کلیدواژه "اضافه بار آهن" در نشریات گروه "پزشکی"

Blood transfusion in thalassemia patients has side effects such as endocrine iron overload. It is necessary to use iron chelators. The aim is to investigate the prevalence of hypothyroidism and its relationship with the level of iron overload and the results of the heart and liver MRI as a new method for diagnosing iron deposition, and iron removal treatment. Determining the factors affecting this complication can help prevent or improve it.

This cross-sectional study was conducted on 232 beta-thalassemia major and intermedia patients of Tehran adult thalassemia clinic in the year 1400 who were selected by convenient sampling method. The comparison of the level of thyroid hormones and ferritin was done with Chi-squared, independent t, Mann-Whitney and Kruskal-Wallis tests by SPSS 26.

The prevalence of hypothyroidism in patients with an average age of 40.79 ± 9.02 year was 27.6% There was no significant relationship between hypothyroidism with ferritin levels or heart and liver iron deposition. TSH level was significantly (p= 0.01) higher in men than women. Most of patients used combined iron chelators, but the type of drug was not significantly different.

It seems that iron overload may be effective in hypothyroidism, but it does not necessarily lead to it. Despite the treatment of iron deficiency, this complication is still one of the main problems. It is suggested to consider the amount of iron load and iron removal treatment before and after the onset of hypothyroidism in future studies.

Cardiac magnetic resonance imaging (MRI) is a costly method to assess cardiac iron overload. The presence of fragmented QRS (fQRS) indicates changes due to iron overload in cardiac tissue. The aim of this study was to evaluate the correlation between fQRS and cardiac iron overload using cardiac MRI in patients with β-thalassemia major (β-TM).

This analytical cross-sectional study was conducted in 40 β-TM patients admitted to Arak Amir-Kabir Hospital, Iran 2018-2019. Cardiac T2* MRI was performed and values of less than 20 ms were considered as cardiac iron overload. The patients were divided into two groups (<20 and >20 ms). The presence of fQRS was assessed on 12-lead surface electrocardiogram (ECG) and compared between two groups.

There was a positive correlation between T2*MRI and serum ferritin (r= 0.041, P=0.657) and hemoglobin levels (r=0.057, P=0.540). The mean T2*MRI in patients with fQRS (18.43±7.24) was significantly lower than patients without fQRS (26.47±6.15) (P=0.001). We found a negative correlation between T2*MRI and fQRS (r= -0.048, P=0.001).

The presence of fQRS on ECGs could be a good predictor of cardiac iron overload in β-TM patients. It is believed that fQRS can indicate this change in electrocardiography and shows the need for more accurate monitoring for cardiac overload and aggressive chelation therapy.

Thalassemia syndromes are the most common inherited hemoglobinopathies in the world characterized by various degrees of defective production of the alpha or beta globin chains. Impairment in alpha chain or beta chain synthesis leads to alpha thalassemia and beta thalassemia syndromes respectively.
Iran is one of the countries located on the thalassemia belt therefore this disease is significant in our country. The most important component of treatment in beta thalassemia is packed red blood cell transfusion. Thalassemic patients need lifelong transfusions and the consequence of these repeated transfusions is iron accumulation in different organs, such as heart, liver and endocrine gland. Iron overload is one of the major causes of morbidity in patients with thalassemia major necessitating iron chelation drugs to improve survival of patients. Three iron chelating agents are currently commercially available: deferoxamine (DFO), deferiprone (DFP), and deferasirox (DFX). DFO is the first chelating agent that became available. DFP is the first oral iron chelator and DFX is the most recently approved chelator for transfusional hemosiderosis. The purpose of this article is to summarize the main pharmacokinetic characteristics and side effects of iron chelator drugs in the field of thalassemia.

Accumulation of iron is the most common consequences of repeated blood transfusions in β-thalassemia major patients. Iron chelating effects of alpha-lipoic acid have been reported by several studies. The aim of this study was to investigate effects of supplementation with alpha-lipoic acid, as a chelator, on serum iron and hematological indices in these patients.

Twenty-two β-thalassemia major patients were selected to receive 600 mg alpha-lipoic acid or placebo capsules for 8 w. After a 3-week washout period, order of intervention was replaced as patients who previously received placebo were administered the supplement vise versa for another 8 w. At the end of the study, changes in serum iron, total iron binding capacity and hematological parameters between the treatments were assessed.

Serum concentrations of iron and total iron binding capacity and hematological parameters did not change within the supplementation (p > 0.05). Changes in iron, total iron binding capacity and hematological indices were not significantly different between the two interventions (p > 0.05). White blood cell counts in placebo use increased significantly in males (p = 0.04). The mean corpuscular hemoglobin in placebo patients decreased significantly in all patients and males (p = 0.02 for both).

Results of this study revealed that alpha-lipoic acid supplementation included no beneficial effects on iron, total iron binding capacity and hematological indices in β-thalassemia major patients. Further studies with more participants and longer times are indispensable.

Background and

The diagnosis of iron overload in various organs such as heart and liver in patients with blood-transfusion-dependent thalassemia can greatly improve their quality of life. In this study, we investigated the relationship of T2*-weighted magnetic resonance imaging (MRIT2*) of heart and liver with ferritin levels; also assessed the factors affecting iron overload using generalized estimation equations (GEE).

53 patients with thalassemia major in Dr. Mohamed Kermanshahi hospital, Kermanshah, Iran, during 2011-12 were enrolled. To investigate the relationship of MRIT2* of heart and liver with serum ferritin levels in addition to linear models, quadratic, exponential and logarithmic data were fitted well. To identify factors influencing iron overload, generalized estimation equations was used.

Exponential model was more appropriate to describe the relationship of serum ferritin levels with MRIT2* of heart (R2 = 0.170) and quadratic model was more appropriate for liver (R2 = 0.277). Generalized estimation equations model showed that ferritin level (P < 0.001), splenectomy status (P < 0.001), desferal (P < 0.001), and osveral (P < 0.001) affected the iron overload.

Using generalized estimation equations model for longitudinal studies and studies of correlation between response variables is more reliable and needs smaller sample.