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Frequency and distribution of asymptomatic brain lesions in patients with β-thalassemia intermedia

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Abstract

We aimed to determine the frequency of asymptomatic brain lesions in a group of patients with β-thalassemia intermedia (β-TI) and to evaluate correlation of asymptomatic brain lesions with splenectomy, thrombocytosis, blood transfusions, and clinical parameters. Ninety five neurologically intact patients with β-TI were randomly enrolled in this cross-sectional study. Diffusion-weighted imaging brain MRI was performed in every patient to detect cerebral white matter lesions (WML). We found an overall frequency of 15 (15.8 %) for WMLs, 14 (23.7 %) in splenectomized, and 1 (2.8 %) in nonsplenectomized patients. The presence of WML was significantly associated with splenectomy (P = 0.008) and thrombocytosis (P = 0.009). However, after adjustment for splenectomy, thrombocytosis was not significantly associated with the presence of WML (P > 0.05). The number of patients with regular blood transfusions and normal MRI was not significantly higher compared to those with abnormal findings (52.5 % vs. 26.7 %; P = 0.092). In untransfused patients, hydroxyurea (HU) administration was associated with a lower incidence of WML (P < 0.001). Although in univariate analysis either splenectomy or thrombocytosis showed significant correlation with the presence of single or multiple WMLs, thrombocytosis by itself did not significantly contribute in developing asymptomatic brain lesions. The lack of significant correlation between lesions and regular blood transfusions could be related to the treatment with HU in untransfused patients, which increased fetal hemoglobin levels and improved the morphology and the pathological indices of the red blood cells. Larger prospective studies are suggested for the accurate evaluation of the correlation of these factors with developing asymptomatic brain lesions.

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Acknowledgments

We would like to thank Shiraz University of Medical sciences for financial and approval support and MRI technicians of Faghihi Hospital Shiraz, Iran.

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Authors and Affiliations

  1. Hematology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

    Mehran Karimi, Sezaneh Haghpanah & Mohammad Reza Bordbar

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

    Mohammad Hadi Bagheri & Parisa Pishdad

  3. Medicine and Pediatrics, New York Cornell University Presbyterian Hospital, New York, USA

    Eliezer A. Rachmilewitz

Authors
  1. Mehran Karimi
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  2. Sezaneh Haghpanah
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  3. Mohammad Hadi Bagheri
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  4. Mohammad Reza Bordbar
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  5. Parisa Pishdad
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  6. Eliezer A. Rachmilewitz
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Correspondence to Mehran Karimi.

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Karimi, M., Haghpanah, S., Bagheri, M.H. et al. Frequency and distribution of asymptomatic brain lesions in patients with β-thalassemia intermedia. Ann Hematol 91, 1833–1838 (2012). https://doi.org/10.1007/s00277-012-1527-x

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  • DOI: https://doi.org/10.1007/s00277-012-1527-x

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