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| IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711 |
Int J Clin Exp Med 2010;3(2):122-128
Original Article
Deferiprone challenge test for monitoring iron overload in hepatitis positive
thalassemic major patients
Dilshad A. Khan, Asma N. Cheema, Masood Anwar, Farooq A. Khan
Department of Pathology Army Medical College, National University of Sciences and Technology, Islamabad,
Pakistan; Islamic International Medial College, Riphah University, Islamabad, Pakistan.
Received January 20, 2010, accepted April 15, 2010, available online April 30, 2010
Abstract: Viral hepatitis is common among β-thalassemia major (BTM) children in Pakistan. Transfusional iron overload
in BTM is usually monitored by serum ferritin. But its levels are falsely raised in viral hepatitis and do not reflect
the true iron body burden in thalassemic patients. The objective of the study was to develop a test for monitoring iron
overload in ‘Hepatitis B&C’ positive BTM patients by urinary iron excretion (UIE) after oral deferiprone chelation as
compared to serum ferritin. We recruited 130 BTM patients from the registry of Thalassaemia centre at Rawalpindi,
Pakistan. The patients were grouped into Hepatitis positive and Hepatitis negative based on ELISA test. Serum ferritin
levels were analyzed by kit on Access II. Each patient was given 75mg/kg of deferiprone at morning. Baseline UIE
before deferiprone, and 4, 8 12 hours (hrs) UIE after deferiprone were analyzed on Selectra E. One hundred and thirty
BTM patients aged 3 to 23 years comprising of Hepatitis positive (n=69) and Hepatitis negative (n=61) participated
in the study. Hepatitis positive thalassemic patients had significantly high serum ferritin median (IQ) 4349 (2782-
5927) μg/L than 3338 (2189-5506) μg/L in the Hepatitis negative (p=0.001). We did not find any significant change
in UIE at 4, 8, and 12 hours between two groups after Deferiprone intake (p=NS). We observed significant positive
correlation between serum ferritin and 4 hours UIE in Hepatitis negative patients (r=0.57; p=0.01) but not in the
Hepatitis positive patients (r=0.16; p=NS). Deferiprone challenge with measurement of 4 hours UIE is cost effective
and non-invasive test rather than serum ferritin for monitoring iron overload in Hepatitis’ positive BTM patients.(IJCEM1001006).
Key words: Thalassemia major, iron overload, hepatitis, serum ferritin, deferiprone challenge test, monitoring of iron
overload, deferiprone challenge test
Full Text PDF
Address all correspondence to:
Dilshad Ahmed, PhD
Khan, Department of Pathology, Army Medical
College, Abid Majeed Road, Rawalpindi-Pakistan,
Tel:+92-03005147938, Fax +92-051-5529988
Email: dilshad@nust.edu.pk, or dilshad56@yahoo.com
Original Article
Deferiprone challenge test for monitoring iron overload in hepatitis positive
thalassemic major patients
Dilshad A. Khan, Asma N. Cheema, Masood Anwar, Farooq A. Khan
Department of Pathology Army Medical College, National University of Sciences and Technology, Islamabad,
Pakistan; Islamic International Medial College, Riphah University, Islamabad, Pakistan.
Received January 20, 2010, accepted April 15, 2010, available online April 30, 2010
Abstract: Viral hepatitis is common among β-thalassemia major (BTM) children in Pakistan. Transfusional iron overload
in BTM is usually monitored by serum ferritin. But its levels are falsely raised in viral hepatitis and do not reflect
the true iron body burden in thalassemic patients. The objective of the study was to develop a test for monitoring iron
overload in ‘Hepatitis B&C’ positive BTM patients by urinary iron excretion (UIE) after oral deferiprone chelation as
compared to serum ferritin. We recruited 130 BTM patients from the registry of Thalassaemia centre at Rawalpindi,
Pakistan. The patients were grouped into Hepatitis positive and Hepatitis negative based on ELISA test. Serum ferritin
levels were analyzed by kit on Access II. Each patient was given 75mg/kg of deferiprone at morning. Baseline UIE
before deferiprone, and 4, 8 12 hours (hrs) UIE after deferiprone were analyzed on Selectra E. One hundred and thirty
BTM patients aged 3 to 23 years comprising of Hepatitis positive (n=69) and Hepatitis negative (n=61) participated
in the study. Hepatitis positive thalassemic patients had significantly high serum ferritin median (IQ) 4349 (2782-
5927) μg/L than 3338 (2189-5506) μg/L in the Hepatitis negative (p=0.001). We did not find any significant change
in UIE at 4, 8, and 12 hours between two groups after Deferiprone intake (p=NS). We observed significant positive
correlation between serum ferritin and 4 hours UIE in Hepatitis negative patients (r=0.57; p=0.01) but not in the
Hepatitis positive patients (r=0.16; p=NS). Deferiprone challenge with measurement of 4 hours UIE is cost effective
and non-invasive test rather than serum ferritin for monitoring iron overload in Hepatitis’ positive BTM patients.(IJCEM1001006).
Key words: Thalassemia major, iron overload, hepatitis, serum ferritin, deferiprone challenge test, monitoring of iron
overload, deferiprone challenge test
Full Text PDF
Address all correspondence to:
Dilshad Ahmed, PhD
Khan, Department of Pathology, Army Medical
College, Abid Majeed Road, Rawalpindi-Pakistan,
Tel:+92-03005147938, Fax +92-051-5529988
Email: dilshad@nust.edu.pk, or dilshad56@yahoo.com
