Only 14 pages are availabe for public view
-thalassemia and Sickle cell disease are two of the most common hemoglobinopathies in the Middle East countries and in Egypt. These hemoglobin disorders lead to chronic anemia with secondary iron overload either due to body response by increasing intestinal iron absorption or due to regular/ cyclic transfusion therapies used to control the anemia complications.
Secondary iron overload occurs in such groups of patients with iron deposition in multiple vital organs as the liver, heart and endocrinal glands causing their cellular damage by the release of toxic free radicles.
MRI is used now as a reliable, safe and non-invasive method for iron assessment and used internationally for following up of chelation therapy especially in the liver and heart. This was established due to the fact that iron has paramagnetic properties which cause the surrounding water protons to dephase more rapidly causing more rapid loss of signal in T2 weighted images.
Many studies showed that the patients with B-thalassemia and Sickle cell disease develop decrease in their neurocognitive and psychological functions. chronic anemia, hypoxia and side effects of the chelation therapy were some of the risk factors of such neuroaffection. However, the recent question of interest was; whether the excess brain iron deposition is another culprit for brain neurocognitive affection or not.
Multiple studies were conducted to show great differences in their results regarding the brain iron deposition. Some studies showed areas in the brain with high iron deposition, but they weren’t in other studies.
Our study showed that there was no significant differences in the R2* values of the caudate and thalamic regions (left and right sides) between healthy controls, B-thalassemia and SCD groups, for exception of a moderate significant difference in the left thalamic region (p= 0.021) between the B-thalassemia and healthy control groups.
Finally, our study suggested that no brain iron overload occurs in group of patients. This may be attributed to the heavy chelation therapy given to them in our institute that makes cardiac affection rarely occurred. However, more broad studies with larger cohorts are recommended to set international grading system or cut off values for the brain iron content above which iron overload should be considered