Skip to main content

Advertisement

SpringerLink
Log in

Incidence of testicular microlithiasis in patients with β-thalassemia major

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

We assessed the prevalence of testicular microlithiasis by scrotal ultrasonography in β-thalassemia major patients older than 10 years and evaluated the association with serum ferritin levels, calcium (Ca), phosphate (Ph), and parathyroid hormone levels (PTH). In this cross-sectional study, 132 male β-thalassemia major patients from 300 male patients older than 10 years old were randomly evaluated by scrotal ultrasonography. Parathyroid hormone, calcium, phosphate, and serum ferritin levels were also evaluated. All of the patients were urologically asymptomatic. One hundred healthy age-matched subjects were selected as control group. Testicular microlithiasis was found in 16 patients and 1 individual in control group (12.1 vs 1 %; p = 0.003). Testicular microlithiasis was associated with age and high serum ferritin levels, but there was no association between Ca, Ph, and PTH levels; blood transfusion; and oral or subcutaneous iron chelation therapy. Also, there was no significant correlation between hyperparathyroidism, history of viral hepatitis, and splenectomy with testicular microlithiasis. The frequency of testicular microlithiasis in β-thalassemia major patients was higher than previously reported. A correlation was found between testicular microlithiasis with age and serum ferritin levels, so regular and adequate iron chelator therapy (at least 10–12 h per day for 5–6 days a week) is recommended. We suggest a close observation and treatment with iron-chelating agents of these patients. Since testicular microlithiasis is occasionally associated with germ cell tumors, clinical and sonographic follow-up is recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Haghpanah S, Nasirabadi S, Ghaffarpasand F, Karami R, Mahmoodi M, Parand S, Karimi M (2013) Quality of life among Iranian patients with beta-thalassemia major using the SF-36 questionnaire. Sao Paulo Med J 131:166–72

    PubMed  Google Scholar 

  2. Shamshirsaz AA, Bekheirnia MR, Kamgar M, Pourzahedgilani N, Bouzari N, Habibzadeh M, Hashemi R, Shamshirsaz AA, Aghakhani S, Homayoun H, Larijani B (2003) Metabolic and endocrinologic complications in beta-thalassemia major: a multi center study in Tehran. BMC Endocr Disord 3:4

    Article  PubMed Central  PubMed  Google Scholar 

  3. Karimi M, Emadmarvasti V, Hoseini J, Shoja L (2011) Major causes of hospital admission in beta thalassemia major patients in Southern Iran. Iran J Pediater 21:509–13

    Google Scholar 

  4. Derakhshan A, Karimi M, Ghadimi Moghadam A (2008) Comparative evaluation of renal finding in beta-thalassemia major and intermedia. Saudi J Kidney Dis Transpl 19:206–9

    Google Scholar 

  5. Galanello R, Origa R (2010) Beta-thalassemia. Orphanet J Rare Dis 5:11

    Article  PubMed Central  PubMed  Google Scholar 

  6. Pignatti C, Rugolotto S, De Stefano P (2004) Survival and complications in patients with thalassemia major treated with transfusion and deferoxamine. Haematologica 89:1187–93

    Google Scholar 

  7. De Sanetis V, Eleftheriou A, Malaventura C (2004) Prevalence of endocrine complications and short stature in patients with thalassemia major. Pediatr Endocrinol Rev 2:249–55

    Google Scholar 

  8. Alaee A, Miabi Z (2007) Beta-thalassemia major, a cause of testicular microlithiasis. Iranian Red Cresc Med J 9:212–14

    Google Scholar 

  9. Backus ML, Mack LA, Middleton WD, King BF, Winter TC, True LD (1994) Testicular microlithiasis: imaging appearance and pathologic correlation. Radiology 192:781–5

    Article  CAS  PubMed  Google Scholar 

  10. Duchek M, Bergh A, Oberg L (1991) Painful testicular lithiasis. Scand J Urol Nephrol Suppl 138:231–3

    CAS  PubMed  Google Scholar 

  11. De Govveia Brazao CA, Pierik F, Oosterhuis JW, Dohle GR, Looijenga LH (2004) Bilateral testicular microlithiasis predicts the presence of precursor of testicular germ cell tumors in subfertile men. J Urol 171:158–60

    Article  Google Scholar 

  12. Parenti G, Zago S, Lusa M, Campioni P, Mannella P (2007) Association between testicular microlithiasis and primary malignancy of testis. Radiol Med 112:588–96

    Article  CAS  PubMed  Google Scholar 

  13. Coffey J, Huddart RA, Sohaib SA, Parker E, Dudakia D, Pugh JL, Easton DF, Bishop DT, Stratton MR, Rapley EA (2007) Testicular microlithiasis as a familial risk factor for testicular germ cell tumor. Br J Cancer 97:1701–6

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Goede J, Hack W, Voort-Doedens LM, Pierik FH, Looijenga LH, Sijstermans K (2010) Testicular microlithiasis in boys and young men with congenital or acquired undescended (ascending) testis. J Urology 183:1539–44

    Article  Google Scholar 

  15. Chiang LW, Yap TL, Asiri MM, Phaik Ong CC, Low Y, Jacobsen AS (2012) Implications of incidental finding of testicular microlithiasis in pediatric patients. Pediatr Urol 8:162–5

    Article  Google Scholar 

  16. Kosan M, Gonulalan U, Ugurlu O, Oztekin V, Akdemir O, Adsan O (2007) Testicular microlithiasis in patients with scrotal symptoms and its relationship to testicular tumors. Urology 70:1184–86

    Article  PubMed  Google Scholar 

  17. Korde LA, Premkumar A, Mueller C, Rosenberg P, Soho C, Bratslavsky G, Greene MH (2008) Increased prevalence of testicular microlithiasis in men with familial testicular cancer and their relatives. Br J Cancer 99:1748–53

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Ahmad I, Krishna N, Clark R, Nairn R, Al-Saffar N (2007) Testicular microlithiasis: prevalence and risk of concurrent and interval development of testicular tumor in a referred population. Int Urol Nephrol 39:1177–81

    Article  PubMed  Google Scholar 

  19. Van Casteren NJ, Looijenga LH, Dohle GR (2009) Testicular microlithiasis and carcinoma in situ overview and proposed clinical guideline. Int J Androl 32:279–87

    Article  PubMed  Google Scholar 

  20. Dagash H, Mackinnon E (2007) Testicular microlithiasis: what does it mean clinically? BJU Int 99:157–60

    Article  PubMed  Google Scholar 

  21. Yee WS, Kim YS, Kim SJ, Choi JB, Kim SI, Ahn HS (2011) Testicular microlithiasis: prevalence and clinical significance in population referred for scrotal ultrasonography. Korean J Urol 52:172–7

    Article  PubMed Central  PubMed  Google Scholar 

  22. Slaughenhoopt B, Kadlee A, Schrepferman C (2009) Testicular microlithiasis preceding metastatic mixed germ cell tumor—first pediatric report and recommended management of testicular microlithiasis in the pediatric population. Urology 73:1029–31

    Article  Google Scholar 

  23. Rashid H, Louis R, Weinberg E, Messing E (2004) Testicular microlithiasis: a review and its association with testicular cancer. Urol Oncol 22:285–9

    Article  PubMed  Google Scholar 

  24. Sakamoto A, Shichizyou T, Saito K, Okumura T, Ogawa Y, Yoshida H, Kushima M (2006) Testicular microlithiasis identified ultrasonographically in Japanese adult patients: prevalence and associated conditions. Urology 68:636–41

    Article  PubMed  Google Scholar 

  25. Peterson AC, Buaman JM, Light DE, McMann LP, Costabile RA (2001) The prevalence of testicular microlithiasis in an asymptomatic population of men 18 to 35 years old. J Urol 166:2061–4

    Article  CAS  PubMed  Google Scholar 

  26. Derogee M, Bevers RF, Prins HJ, Jonges TG, Elbers FH, Boon TA (2001) Testicular microlithiasis, a premalignant condition: prevalence, histopathologic finding, and relation to testicular tumor. Urology 57:1133–7

    Article  CAS  PubMed  Google Scholar 

  27. Kim B, Winter TC 3rd, Ryu JA (2003) Testicular microlithiasis: clinical significance and review of the literature. Eur Radiol 13:2567–76

    Article  PubMed  Google Scholar 

  28. Serter S, Gümüş B, Unlü M, Tunçyürek O, Tarhan S, Ayyildiz V, Pabuscu Y (2006) Prevalence of testicular microlithiasis in asymptomatic population. Scand J Urol Nephrol 40:212–4

    Article  PubMed  Google Scholar 

  29. Ringdahl E, Claybrook K, Teague L, Northrup M (2004) Testicular microlithiasis and its relation to testicular cancer on ultrasound findings of symptomatic men. J Urol 172:1904–6

    Article  PubMed  Google Scholar 

  30. Soroosh Z, Ghanaati H, Ayati M (2003) Testicular microlithiasis is it a precancerous state? Iran J Radiol 1:137–40

    Google Scholar 

  31. Chen JL, Chou YH, Tiu CM, Chiou HJ, Wang HK, Chiou SY, Liang IP, Lee CH, Chang CY (2010) Testicular microlithiasis: analysis of prevalence and associated testicular cancer in Taiwanese men. J Clin Ultrasound 38:309–13

    PubMed  Google Scholar 

  32. Origa R, Bina P, Agus A, Crobu G, Defraia E, Dessì C, Leoni G, Muroni PP, Galanello R (2005) Combined therapy with deferiprone and desferrioxamine in thalassemia major. Haematologica 90:1309–14

    CAS  PubMed  Google Scholar 

  33. Shanmugasundaram R, Singh JC, Kekre NS (2007) Testicular microlithiasis: is there an agreed protocol? Indian J Urol 23:234–9

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  34. Wasniewska M, Raiola G, Teresa A, Galati MC, Zirilli G, Catena MA, Ascenti G, Arasi S, De Luca F (2009) Gynecomastia disclosing diagnosis of Leydig cell tumour in a man with thalassemia, secondary hypogonadism and testis microlithiasis. Acta Biomed 80:286–8

    PubMed  Google Scholar 

Download references

Acknowledgments

The present article was extracted from the thesis written by Rahil Rahimi and was financially supported by the Shiraz University of Medical Sciences (grant no. 3632). Also, we thank Sheryl Nikpoor for editing and improving the use of English in the manuscript and Shirin Parand for preparation of the manuscript.

Conflict of interest

The authors have no conflicts of interest to declare.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Shiraz University of Medical Science, Shiraz, Iran

    Rahil Rahimi & Shohreh Jelodari

  2. Medical Imaging Research Center, Shiraz University of Medical Science, Shiraz, Iran

    Amin Abolhasani Foroughi

  3. Hematology Research Center, Shiraz University of Medical Science, Shiraz, Iran

    Sezaneh Haghpanah & Mehran Karimi

  4. Department of Pediatrics, Fasa University of Medical Science, Fasa, Iran

    Maryam Bahmanyar

  5. Pediatric and Adolescent Outpatient Clinics, Quisisana Hospital, Ferrara, Italy

    Vincenzo De Sanctis

  6. Pediatrics Hematology and Oncology, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Mehran Karimi

Authors
  1. Rahil Rahimi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amin Abolhasani Foroughi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sezaneh Haghpanah
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maryam Bahmanyar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shohreh Jelodari
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vincenzo De Sanctis
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mehran Karimi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mehran Karimi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rahimi, R., Foroughi, A.A., Haghpanah, S. et al. Incidence of testicular microlithiasis in patients with β-thalassemia major. Ann Hematol 94, 1785–1789 (2015). https://doi.org/10.1007/s00277-015-2465-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-015-2465-1

Keywords

Search

Navigation