T2 Relaxation Time of the Pituitary Gland in Patients with Beta-Thalassemia and its Relation to Iron Overload and Somatic and Sexual Development | ||
| Journal of High Institute of Public Health | ||
| Article 1, Volume 34, Issue 4, October 2004, Pages 727-746 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/jhiph.2004.180983 | ||
| Authors | ||
| A Ghanem1; A Sakr2; Y Ammar3; H Nono4 | ||
| 1Department of Haematology, Medical Research Institute, Alexandria University, Egypt | ||
| 2Department of Radiodiagnosis, Medical Research Institute, Alexandria University, Egypt | ||
| 3Department of Internal Medicine, Medical Research Institute, Alexandria University, Egypt | ||
| 4Department of Biochemistry, Faculty of Medicine, Alexandria University, Egypt | ||
| Abstract | ||
| Chelation therapy with deferoxamine mesylate [DFO] has revolutionized management of transfusion-dependent β-thalassaemia, but monitoring of tissue iron deposition, particularly in the endocrine glands, is still largely empirical. Clinical, haematological, and endocrinal evaluation of 54 transfusion-dependent β-thalassaemic patients and 25 age- and sex-matched controls was done. Pituitary T2 relaxation time was studied in them by Magentic Resonance Imaging [MRI] to evaluate pituitary iron overload. Thalassaemic patients had significantly lower mean stature, growth velocity, and more delayed pubertal stage. Sixty per cent of thalassaemic females had amenorrhoea, either 1ry or 2ry. Serum insulin-like growth factor 1 [IGF-1] and luteniing hormone [LH] were significant lower in thalassaemic patients compared with controls. Serum growth hormone [GH] and follicule stimulating hormone [FSH] were also lower, but the difference was not statistically significant. Pituitary T2 relaxation rate was significantly higher in patients compared with controls. Serum ferritin in thalassaemic patients showed a statistically significant positive correlation with pituitary T2 relaxation time, and a statistically significant negative correlation with serum IGF-1. It was concluded that monthly follow up of hemoglobin level and serum ferritin are vital to guide a satisfactory transfusion/chelation regimen in thalassaemic patients. However, once a diviation arises in physical/sexual development, measurement of GH, IGF1, FSH, and LH is warranted. Patients with clinical and/or laboratory evidence of pituitary dysfunction will benefit from an MRI study to assess pituitary iron deposition and provide a better guide for the intensity of chelation therapy | ||
| Keywords | ||
| T2 Relaxation; Pituitary Gland; Beta-Thalassemia; Iron Overload | ||
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