Assessment of Iron Overload and Liver Dysfunction by Estimation of S. Ferritin and Liver Enzymes in Transfusion Dependent ?-Thalassemia Patients

ABSTRACT

Introduction: -thalassemia is the most frequent single genedisorder in the world. As a result of repeated transfusions,significant hepatic fibrosis develops over time and itsprogression is directly related to degree of iron overload. In thepresent study we investigated the relationship between theextent of hepatocellular injury as reflected by liver functiontests (LFTs) and serum ferritin.Materials and Methods: It was an analytical cohort studycarried out during the time period from January 2017 to June2018 from High Performance Liquid Chromatography (HPLC)confirmed -thalassemia patients, dependant on regular bloodtransfusion.Results: Our study included 58 (58%) male patients and 42(42%) female patients. Level of Hemoglobin and Packed cellvolume (PCV) increased after 6 months of chelation therapycompared to pre-chelation levels. Whereas, the S. Ferritin andLiver enzymes levels decreased after 6 months of initiation ofchelation therapy.Conclusion: High S. ferritin is a sensitive predictor of hepaticdysfunction, hence, it is a good and reliable non-invasivescreening test for iron overload but it is not a good indicator ofdisease progression, as it has low specificity above levels of2500 ng/ml. Combination therapy with deferiprone anddeferasirox is more effective than either drug alone.