MRI Examinations For Thalassemia Major Patients

Thalassemia major patients require life-long transfusion chelation to avoid premature death due to organ damage by hemosiderosis. The leading cause of death is cardiac failure, but many patients also suffer from endocrine damage such as pituitary failure, hypogonadism, diabetes mellitus, and hypothyroid and hypoparathyroidism.
Even aggressive deferoxamine chelation, does not provide complete cardiac and endocrine protection. The availability of new oral iron chelating agents1,2 and cardiac T2* magnetic resonance imaging (MRI) has revolutionized thalassemia management.3 There are still few reports, however, on the use of MRI to study iron deposits in the endocrine organs. Pancreatic hemosiderosis can cause insulin dependent diabetes mellitus.
This can be rapid in onset and is largely irreversible. The incidence of impaired glucose tolerance and diabetes in thalassemia major patients varied from 9% to 15%, depending on the age of assessment, the intensity of chelation and transfusion and related patient compliance.4,5 It is uncertain whether early assessment and tailored chelation can prevent diabetes and preserve pancreatic reserve. The current study explores the utility of pancreatic MRI in thalassemia major cases.