Ferritin and genu joints ultrasound in major-beta thalassemia

Soewondo Widiastuti; Arif Wibowo Nur; Hanafi Muchtar; Tjandra Irawan Amelia; Kusumaningrum Sulistyani; Riza Muhammad; Probandari Ari; Maharina Luths

doi:10.30574/gscarr.2020.5.3.0132

Authors

Soewondo Widiastuti Radiology Department of Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Indonesia.
Arif Wibowo Nur Radiology Department of Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Indonesia.
Hanafi Muchtar Radiology Department of Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Indonesia.
Tjandra Irawan Amelia Radiology Department of Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Indonesia.
Kusumaningrum Sulistyani Radiology Department of Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Indonesia.
Riza Muhammad Pediatric Department of Dr.Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Indonesia.
Probandari Ari Public Health Department, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Indonesia.
Maharina Luths Radiology Department of Dr. Moewardi Public Hospital, Faculty of Medicine, Universitas Sebelas Maret, Surakarta Indonesia.

DOI:

https://doi.org/10.30574/gscarr.2020.5.3.0132

Keywords:

Ferritin, Genu, Beta-thalassemia, Ultrasound

Abstract

Objective: This study aims to determine whether there is a relationship between ferritin levels and the ultrasound of genu joints in Major-beta Thalassemia patients who undergo repeated transfusions.

Methods: 43 major-beta thalassemia patients who met the inclusion criteria had their genu joint examined by ultrasonography in the Radiology Department of Dr. Moewardi Hospital Surakarta. We analyzed several variables related to synovial thickening, synovial vascularization and joint effusion in these patients.

Results: From 43 samples, the median value of ferritin was 2976.8 (702.2-8897.7) ng/mL and the median of average transfusion was 15 (5-67) times. Analysis with Mann Whitney's non-parametric hypothesis test showed a statistically significant relation between ferritin levels and the presence or absence of ultrasonographic genu joint manifestations in general (p = 0.006) and hypoechoic synovial joint thickening (p = 0.020)

Conclusion: Major-beta thalassemia patients with ferritin levels> 2976.8 ng/mL had a 1.73 times higher risk for thickening of the synovial joints and 1.50 times higher for having genu joint manifestations. The frequency of transfusion showed a statistically significant relationship with the thickening of the synovial joint. Repeated transfusions more than 15 times increased the prevalence of the synovial joints thickening by 1.57 times.

Metrics

Metrics Loading ...

References

Wahidiyat I. Thalassemia dan Permasalahannya di Indonesia. Naskah Lengkap Konika XI. IDAI: Jakarta. 2009.

Abetz L, Baladi JF, Jones P, Rofail D. The impact of iron overload and its treatment on quality of life: result from a literature review. Health and Quality of life outcomes. 2006; 4: 73.

Malik S, Syed S, Ahmed N. Complications in transfusion–dependent patients of ß-thalassemia major. 2009.

Karimi M, et al. Prevalence of hepatosplenomegaly in beta thalassemia minor subjects in Iran. European Journal of Radiology. 2009; 69: 120-2.

Thalassemia International Federation: Guidelines for the clinical management of thalassemia 2nd edition. 2008.

Borgna-Pignatti C, Galanello R. Thalassemias and related disorders: quantitative disorders of hemoglobin synthesis. In Wintrobe's Clinical Hematology Volume 42. 11th edition. Lippincott Williams & Wilkins. Philadelphia. 2004; 1319-1365.

Mishra AK, Tiwari A. Iron overload in beta thalassaemia major intermedia patients. Maedica. 2016; 8(4): 328-32.

Wang W, Knovich MA, Coffman LG, Torti FM, Torti SV. Serum ferritin: past, present and future. Biochimica et Biophysica Acta. 2010; 1800(8): 760–9.

Pootrakul P, Vongsmassa V. Serrum Ferritin Level in Thalassemias and The Effect of Splenectomy. Acta Haematologica. 1984; 66(4): 244-50.

Riaz H, et al. Serum ferritin levels, socio-demographic factors and desferrioxamine therapy in multi-transfused thalassemia major patients at a government tertiary care hospital of Karachi, Pakistan. BMC Research Notes. 2011; 287.

University of Rochester Medical Center. Ferritin (Blood).

Minardi J, Denne N, Miller M, Larrabee H, Lander O. Acute arthritis of the hip--case series describing emergency physician performed ultrasound guided hip arthrocentesis. W V Med J. 2013 Sep-Oct; 109(5): 22-4.

Atta D, Elsoaud AA, Hesham E, et al. Ultrasonography of the extremity. International Journal of Advanced Research. 2015; 3(10): 959-969.

Trachtenberg F, Foote D, Martin M, Carson S, Coates T, Beams O, Vega O, Merelles-Pulcini M, Giardina PJ, Kleinert DA, Kwiatkowski J, Thompson AA, Neufeld EJ, Schilling L, Thayalasuthan V, Pakbaz Z, Yamashita R. Pain as an emergent issue in thalassemia. Am J Hematol. 2010; 85(5): 367–70.

Noureldine MHA. Rheumatological complications of beta-thalassemia: an overview. Rheumatology. 2018; 57(1): 19-27.

Choudhry VP, Pati HP, Saxena A, Malaviya AN. Deferiprone, efficacy and safety. Indian J Pediatr. 2004; 71: 213–6.

Rheumatology Network. Identifying and managing hemochromatosis arthropathy. 2009.

Mathiessen A, Conaghan PG. Synovitis in osteoarthritis: current understanding with therutapeutic implications. Arthritis Research & Therapy. 2017; 19(8).

Carotti M, et al. Power Doppler sonography in the assessment of synovial tissue of the knee joint in rheumatoid arthritis: a preliminary experience. Ann Rheum Dis. 2002; 61: 877-82.

Jacobson JA. Knee Ultrasound. Fundamentals of Musculoskeletal Ultrasound. 2007; 238-239.

Greenland S, et al. Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations. Eur J Epidemiol. 2016; 31: 337-50.