Serum ferritin levels in comparison with mri in the clinical management of β-thalassemia major

Background: Iron overload is a serious complication in patients with beta thalassemia major (β-TM) resulting in cardiomyopathy, liver cirrhosis and arrhythmias. Assessing iron overload regularly in these patients is imperative for initiating effective chelation therapy. Serum ferritin measurements and Magnetic Resonance Imaging (MRI) offer reliable methods for evaluating iron overload. Objective: In the present study, iron overload was assessed by serum ferritin levels and MRI and the findings were correlated in order to propose serum ferritin as an easy and inexpensive method for evaluating iron overload in thalassemia patients. Methods: A total of 100 β-TM patients aged 8 to 30 years of both sexes who were on regular blood transfusions and chelation therapy were evaluated for various demographic parameters. Complete blood count (CBC) measurements were done using cell counter. Serum ferritin levels were determined using chemiluminescence method and MRI. Results: A moderate negative correlation (r=-0.6037) was observed between the average serum ferritin and T2* Liver and was statistically significant (P<0.0001) which implies that as the average ferritin recorded for thalassemia patients increases, the T2* MRI value reduces which means that severity of iron overload in the liver increases. A weak negative correlation (r=-0.3342) was also seen for average ferritin levels and T2* MRI Heart which was also statistically significant (P=0.0007). Conclusion: A significant negative correlation between serum ferritin levels and MRI T2*liver and heart suggests that serum ferritin levels can be used to diagnose iron over load in patients with thalassemia as an alternative where T2* MRI is not available.