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Association of Hepatic Fibrosis Measured by Transient Elastography with Ferritin Level of Patients with Transfusion Dependent Thalassemia in Iraq | ||
| Al- Anbar Medical Journal | ||
| Volume 21, Issue 3, July 2025, Pages 206-211 PDF (717.85 K) | ||
| Document Type: Original articles | ||
| DOI: 10.33091/amj.2025.158780.2178 | ||
| Authors | ||
| zainab khaleel Gataa* ; Najlaa Bader Al-Awadi; Sura Salman Ejam | ||
| Department of Pathology, College of Medicine, University of Babylon, Babylon, Iraq. | ||
| Abstract | ||
| Background: Regular transfusions in thalassemia major lead to iron buildup, especially in the liver, causing oxidative damage and fibrosis. While liver biopsy remains the gold standard, transient elastography offers a reliable, non-invasive alternative for assessing fibrosis. Objectives: To measure the correlation between hepatic fibrosis assessed by transient elastography with ferritin level in transfusion dependent thalassemia patients. Materials and Methods: A cross-sectional study that included 81 individuals with thalassemia major aged 12 years and older. Participants were collected from the thalassemia center in Najaf. The serum ferritin level, alanine transaminase (ALT) and aspartate transferase (AST) were analyzed from a blood sample obtained from the participants. A fibrosis score was measured in kilopascals (kPa) by transient elastography machine and categorized as (F0 to F1) which indicates absence or minimal hepatic fibrosis (2-7 kPa), (F2) score: Moderate hepatic fibrosis (8-9 kPa), (F3) Significant fibrosis (9-14 kPa); and (F4) score cirrhosis or severe hepatic fibrosis (14 kPa or higher). Result: There were 81 participants, 41 men and 40 were women. The mean age of patients was 22 years. Our result showed about two-thirds of participants had mild fibrosis (F0-F2, 67.9%), while one-third had significant fibrosis (F3-F4, 32.1%). There was a significant correlation (P-value = 0.035) between serum ferritin and liver fibrosis measured by transient elastography. In addition, a statistically significant positive correlation between liver enzymes (ALT, AST) and hepatic fibrosis (P-value = 0.0001) was also confirmed. Conclusion: This study demonstrated a significant linear relationship between serum ferritin levels and the degree of liver fibrosis, as assessed by transient elastography. Incorporating fibroscan, together with ferritin monitoring, may enhance early detection and management of liver complications in this high-risk population. | ||
| Keywords | ||
| Beta thalassemia major; Liver iron content; Ferritin; Transient elastography | ||
| References | ||
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