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Neuroimaging Findings in Pediatric Patients with Thalassemia Major
Yılmaz Akbaş1, Sultan Aydın2, Gökçen Öz Tunçer3
1Department of Pediatric Neurology, Mustafa Kemal University, Antakya 3106, Turkey.
Insights
Cranial MRI revealed intracranial pathology in one-third of pediatric patients with thalassemia major, highlighting the need for neurological monitoring. This study investigated iron accumulation effects in young patients.
Area of Science:
- Pediatric Neurology
- Hematology
- Radiology
Background:
- Thalassemia major is a severe inherited blood disorder.
- Iron accumulation is a common complication in thalassemia major.
- Cranial MRI studies on iron accumulation in pediatric thalassemia major are limited.
Purpose of the Study:
- To detect neurological findings using cranial MRI in pediatric patients with thalassemia major.
- To assess for subclinical neurological complications in this population.
- To investigate the utility of cranial MRI in evaluating iron overload effects.
Main Methods:
- Retrospective study of pediatric patients with thalassemia major.
- Inclusion criteria: patients followed between July 2017 and January 2019.
- All included patients underwent cranial MRI scans.
Main Results:
- 30 pediatric patients with thalassemia major were analyzed.
- 33.3% (10 out of 30) of patients showed intracranial pathologies on cranial MRI.
- Pathologies included cerebral white matter lesions and basal ganglia hyperintensities.
Conclusions:
- A significant proportion of pediatric thalassemia major patients exhibit intracranial pathology on MRI.
- These findings suggest potential subclinical neurological involvement.
- Cranial MRI is a valuable tool for assessing neurological complications in thalassemia major.
Background:
Cranial magnetic resonance imaging (MRI) studies about iron accumulation in children with thalassemia major are quite limited.
Aim:
This study aimed to detect neurological findings with cranial MRIs in the pediatric patients with thalassemia major who did not develop any neurological complications.
Materials And Methods:
Pediatric patients with thalassemia major who followed in the Pediatric Hematology Unit between 1 July 2017 and 1 January 2019 were included in the study. The patients underwent cranial MRI scans.
Results:
A total of 30 patients were included. The median age was 15 (range from 4-18) years old. We found that 7 patients had a splenectomy and 19 of the remaining 23 patients had splenomegaly. In addition, 13 of the patients had hepatomegaly, 10 had skeletal deformities, and 17 had growth retardation. The mean ferritin level was 3772.3 ± 2524.8. We detected various pathologies on cranial MRI images of 10 (33.3%) patients. In 3 of these patients, millimeter-sized ischemia-compatible lesions were found in the cerebral white matter, which did not fit any arterial area, and 5 patients had hyperintense lesions in the basal ganglia.
Conclusion:
Our study is valuable since 1/3 of our pediatric patients with thalassemia major were detected with intracranial pathology.
