Endocrine Abstracts

JOINT673

Background: Patients with thalassemia major are at high risk of endocrine dysfunction and growth impairments due to iron overload in multiple organs. Accurate assessment of iron deposition is crucial for optimizing chelation therapy and mitigating complications. MRI T2* and Ferriscan have emerged as reliable, non-invasive tools for quantifying liver iron concentration (LIC) and detecting iron deposition in endocrine organs.

Objective: This review highlights the benefits of MRI and Ferriscan in diagnosing and managing endocrine and growth abnormalities in thalassemia major by analyzing findings from the past two decades.

Material and Methods: Twenty studies from 2006 to 2023 were reviewed, including a total of over 1,500 patients with thalassemia major. Data were synthesized on MRI T2* and Ferriscan applications for assessing iron burden in endocrine-related organs (pituitary, liver, pancreas, and heart), as well as their correlation with clinical outcomes.

Results: 1. Liver Iron Concentration (LIC): Ferriscan consistently demonstrated high accuracy in LIC quantification, outperforming serum ferritin in patients with moderate-to-severe iron overload (Padeniya et al., 2020; Kildemoes et al., 2023). LIC monitoring significantly improved chelation therapy adherence and reduced overall iron burden (Calvaruso et al., 2014; Nichols-Vinueza et al., 2014).

2. Pituitary Iron and Endocrine Dysfunction: MRI T2* reliably detected pituitary iron deposition, correlating with hypogonadotropic hypogonadism and growth hormone deficiency (Wang et al., 2006; Morad et al., 2021).

3. Pancreatic Iron and Diabetes Risk: Pancreatic T2* showed early iron overload, enabling timely intervention to reduce diabetes risk (Au et al., 2007).

4. Cardiac and Multiorgan Correlations: MRI T2* effectively predicted cardiac iron, reducing cardiac events through tailored chelation (Farhangi et al., 2017; Nichols-Vinueza et al., 2013).

5. Correlation with Endocrinopathies: Higher LIC and cardiac iron levels strongly correlated with endocrine complications, emphasizing the importance of comprehensive iron monitoring (Kanbour et al., 2018; Chirico et al., 2015).

Discussion: MRI T2* and Ferriscan are indispensable in assessing iron deposition and guiding treatment strategies in thalassemia major. By accurately quantifying organ-specific iron levels, they enable early detection and management of endocrine dysfunction, improving growth outcomes and reducing complications.

Conclusion: MRI and Ferriscan significantly enhance diagnostic accuracy and management of endocrine and growth abnormalities in thalassemia major. Their routine use is essential for optimizing patient outcomes by tailoring chelation therapy to mitigate iron overload and prevent long-term complications.