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Assessment of iron stores in children with transfusion siderosis by biomagnetic liver susceptometry

✍ Scribed by Fischer, Roland; Tiemann, Christian D.; Engelhardt, Rainer; Nielsen, Peter; D�rken, Matthias; Gabbe, Erich E.; Janka, Gritta E.


Publisher
John Wiley and Sons
Year
1999
Tongue
English
Weight
150 KB
Volume
60
Category
Article
ISSN
0361-8609

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✦ Synopsis


To investigate the applicability of noninvasive Superconducting Quantum Interference Device (SQUID) biomagnetic liver susceptometry and its limitations in thalassemic children, 23 patients with ␤-thalassemia major and other iron loading anemias (age: 4-16 years) and 16 age-related normal children were studied. Liver iron concentrations ranged from 600 to 11,000 µg/g liver for thalassemic patients and from 60 to 340 µg/g liver for normal patients. Measuring the respective organ volumes by sonography, liver and spleen iron stores, accounting for 80% of total body iron stores, were estimated. Nonliver contributions from the lung or intestine to the measured SQUID signals in the small-sized patients were not observed. Moreover, livers in thalassemia were found to be enlarged by 18% per 1,000 µg/g (r = 0.75, P < 10 -3 ). Serum ferritin values correlate significantly with iron stores (r = 0.64, P < 10 -3 ), but predict iron stores only within large error intervals of 4,000 µg/g liver . Analyzing the experimental data from biomagnetometry and from related transfusion and chelation treatment data within the framework of a two-compartment model, we were able to derive additional information on total body iron elimination and chelation therapy efficacy. The exponential decline of iron stores allows forecast of steady-state conditions of the final iron load for a particular transfusion and chelation therapy regimen.


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