Amany A Mousa1, Mohamed Ghonem1, El Hadidy M Elhadidy1, Emad Azmy2, Magda Elbackry3, Azza A Elbaiomy4, Rasha R Elzehery5, Gehan A Shaker6, Omyma Saleh1. 1. a Department of Internal Medicine, Faculty of Medicine , Mansoura University , Egypt . 2. b Department of Clinical Hematology, Faculty of Medicine , Mansoura University , Egypt. 3. c Department of diagnostic radiology, Faculty of Medicine , Mansoura University , Egypt. 4. d Department of Clinical Pathology, Faculty of Medicine , Mansoura University , Egypt. 5. e Department of clinical pathology, Faculty of Medicine , Mansoura University , Egypt. 6. f Department of Physiology, Faculty of Medicine , Mansoura University , Egypt.
Abstract
OBJECTIVE: to assess the growth and pubertal development among a group of patients with β-Thalassemia Major (β-TM) and to evaluate the role of the pituitary gland and liver MRI signal intensity (SI) reduction in assessing and predicting the clinical severity of growth and pubertal dysfunctions. METHODS: Thirty-eight patients with β-TM were examined and divided into two groups: Group I patients were of normal height and puberty and Group II patients had short statures and hypogonadism. Laboratory investigations included serum ferritin, LH, FSH, prolactin, TSH, and basal and dynamic growth hormones. Pituitary and liver MRIs were performed to assess the pituitary to fat (P/F) and liver to muscle (L/M) signal intensities (SI), respectively. Fifteen healthy and sex- and age-matched subjects were included as controls. RESULTS: Both patient groups had significantly elevated serum ferritin and significantly decreased prolactin and IGF1 compared to control subjects. Group II showed a significant reduction in LH, FSH, and IGF1 and a significant increase in ferritin in comparison with Group I and the control group, and it had a highly significant reduction in both P/F and L/M SI in comparison with Group I (p<0.001 and 0.008, respectively). The reduced P/F ratio was significantly correlated with FSH and LH, and a cutoff for a P/F ratio ≥0.94 was obtained to differentiate between Group I and II. CONCLUSION: MRI in conjunction with the P/F signal intensity ratio is a useful and noninvasive tool for the early diagnosis of pituitary iron overload.
OBJECTIVE: to assess the growth and pubertal development among a group of patients with β-Thalassemia Major (β-TM) and to evaluate the role of the pituitary gland and liver MRI signal intensity (SI) reduction in assessing and predicting the clinical severity of growth and pubertal dysfunctions. METHODS: Thirty-eight patients with β-TM were examined and divided into two groups: Group I patients were of normal height and puberty and Group II patients had short statures and hypogonadism. Laboratory investigations included serum ferritin, LH, FSH, prolactin, TSH, and basal and dynamic growth hormones. Pituitary and liver MRIs were performed to assess the pituitary to fat (P/F) and liver to muscle (L/M) signal intensities (SI), respectively. Fifteen healthy and sex- and age-matched subjects were included as controls. RESULTS: Both patient groups had significantly elevated serum ferritin and significantly decreased prolactin and IGF1 compared to control subjects. Group II showed a significant reduction in LH, FSH, and IGF1 and a significant increase in ferritin in comparison with Group I and the control group, and it had a highly significant reduction in both P/F and L/M SI in comparison with Group I (p<0.001 and 0.008, respectively). The reduced P/F ratio was significantly correlated with FSH and LH, and a cutoff for a P/F ratio ≥0.94 was obtained to differentiate between Group I and II. CONCLUSION: MRI in conjunction with the P/F signal intensity ratio is a useful and noninvasive tool for the early diagnosis of pituitary iron overload.
Entities:
Keywords:
MRI; Pituitary; hypogonadism; short stature; β- Thalassaemia
Authors: Kamil Yılmaz; Ahmet Kan; Mehmet Guli Çetincakmak; V Hulya Uzel; Deniz Yılmaz; Muhammed Akif Deniz; Salih Hattapoglu Journal: Cureus Date: 2021-01-23