الفهرس | Only 14 pages are availabe for public view |
Abstract Patients with SCD have increased effective utilization of iron that lowers their transferrin saturation and risk of extrahepatic iron deposition. However, long-term transfusional exposure and poor compliance to iron chelation therapy eventually overwhelm NTBI buffering capacity, effectively converting the sickle cell iron-overload risk profile to a thalassemia phenotype, causing rapid iron accumulation in the pancreas and heart. MRI is essential for monitoring the overall iron balance in the body as well as for detection of extrahepatic iron deposition. In our study, we noticed absence of correlation between quantitative MRI liver iron concentration (LIC), cardiac T2* and pancreatic R2* which is in our opinion, reflects several issues: first one is the fact that we can’t rely only on liver MRI T2* to predict the exact overall condition of sickle cell patients in Egyptian population. Second issue we can deduct from this work, is that aggressive early chelation, usually used by Egyptian pediatricians, seems to be effective in avoiding excessive iron overload in the body keeping it more localized to target organs like liver and thus preventing severe fatal cardiac complications by limiting cardiac affection. Our data showed that post-processing methods used for evaluation of hepatic and cardiac T2* values can be performed interchangeably within the approaches studied. The availability of any of these software solutions might suffice to allow for clinical interpretation of liver and heart iron overload in MRI centers around the world and to follow up of the effectiveness of iron chelation therapy. |