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Published on: January 29, 2018
Deferoxamine-induced dysplasia-like skeletal abnormalities at radiography and MRI
Hadeel M Seif El Dien1, Reem I Esmail, Rania E Magdy
1Department of Radiology, Cairo University, Cairo, Egypt.
Insights
Deferoxamine treatment for thalassemia major can cause bone dysplasia-like changes in children, even with delayed treatment. These skeletal changes may contribute to joint pain in affected children.
Area of Science:
- Pediatric Hematology
- Skeletal Radiology
- Pharmacology
Background:
- Thalassemia major treatment involves blood transfusions and iron chelation.
- Current treatments can lead to growth disturbances and bone abnormalities.
Purpose of the Study:
- To investigate deferoxamine-induced bone dysplasia-like changes in Egyptian children with thalassemia major.
- To document the spectrum and characteristics of these skeletal changes.
Main Methods:
- A study of 59 Egyptian children with thalassemia major and joint pain.
- Skeletal surveys and knee MRIs were performed.
- Radiographic findings were correlated with patient age, ferritin levels, and treatment duration.
Main Results:
- 37.3% of children exhibited bone dysplasia-like changes, primarily around the knees.
- Changes ranged from mild to severe.
- No significant correlation was found between bone changes and age, treatment onset, duration, or ferritin levels.
Conclusions:
- Deferoxamine therapy can induce a range of bone dysplasia-like changes in children with thalassemia major.
- These skeletal changes are a potential cause of joint pain, particularly in symptomatic children.
- Awareness of these effects is crucial for managing thalassemia major patients.
Background:
Current thalassemia major treatment includes blood transfusion and iron chelation, which is associated with growth disturbances and radiographic changes in the long bone metaphyses.
Objective:
To explore and discuss the spectrum of deferoxamine-induced bone-dysplasia-like changes in children with thalassemia major in Egypt.
Materials And Methods:
We studied 59 Egyptian children with thalassemia major and generalized arthralgia. All started deferoxamine treatment at 3 years of age. We conducted skeletal survey and MRI of both knees in radiographically positive children. Each child's age, serum ferritin, age of onset and duration of therapy were compared with the radiologic findings.
Results:
Twenty-two (37.3%) children had variable degrees of skeletal dysplasia-like changes similar to those described with deferoxamine intake, mostly around the knees. Mild dysplasia-like changes were seen in 4 (18%) children; moderate changes were seen in 11 (50%) children and severe changes were seen in 7 (31.8%) children. No statistically significant relationships were detected between bone changes and the children's age, age of starting deferoxamine, duration of therapy, or serum ferritin level.
Conclusion:
A wider spectrum of deferoxamine-induced bone-dysplasia-like changes was recognized despite delayed onset and small doses of therapy. These changes should be considered as a possible cause of arthropathy in children with thalassemia major, especially symptomatic children.
