Noninvasive assessment and risk factors of liver fibrosis in patients with thalassemia major using shear wave elastography

Hematology. 2019 Dec;24(1):183-188. doi: 10.1080/10245332.2018.1540518. Epub 2018 Nov 19.

Abstract

Objectives: This study aimed to estimate the prevalence of liver fibrosis and assess the risk factors for developing significant liver fibrosis in patients with Thalassemia Major (TM).

Methods: All patients with TM over the age of 10 years were included in the study.

Results: A total of 94 eligible patients underwent 2-D SWE. The median age was 26.7 years. The median of the average 5-year serum ferritin (5yrSF) and liver iron concentration (LIC) assessed by MRI T2* were 1326 µg/L and 6.7 mg/g dw, respectively. Hepatitis C and hepatitis B core antibodies were positive in 38% and 1% of the patients respectively. The proportion of patients with significant fibrosis was 60%. Male gender increased the risk of significant fibrosis (Odds ratio of 0.4; p = .0373). Additionally, the 5yrSF (p = .00661), the LIC (p = .0225) and the lowest LIC of the previous 5 years (p = .0211) were significant. In the multivariable logistic regression model, only 5yrSF (p = .0035) and gender (p = .00984) remained significant.

Conclusions: The risk of liver fibrosis is associated with iron overload and gender in patients with TM.

Keywords: Beta thalassemia major; iron overload; liver fibrosis; risk factors; ultrasound.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Elasticity Imaging Techniques*
  • Female
  • Humans
  • Iron Overload / blood
  • Iron Overload / complications
  • Iron Overload / diagnostic imaging*
  • Iron Overload / therapy
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnostic imaging*
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / therapy
  • Male
  • Risk Factors
  • Sex Factors
  • beta-Thalassemia / blood
  • beta-Thalassemia / complications
  • beta-Thalassemia / drug therapy*
  • beta-Thalassemia / therapy