MAGNETIC-RESONANCE-IMAGING EVALUATION OF THE PITUITARY-GLAND AND HYPOTHALAMUS IN THALASSEMIC CHILDREN WITH ELEVATED SERUM FERRITIN LEVELS

Objective: Despite modern treatment with hypertransfusion and chelatio n therapy, growth retardation continues to be observed in a significan t proportion of thalassaemic children. The underlying reason remains u nclear, but hypothalamic-pituitary axis disorder has been implicated. We aimed to assess iron overloading in the hypothalamus and pituitary gland in thalassaemic children with elevated serum ferritin, with and without growth retardation. Methodology: Twelve thalassaemic children on hypertransfusion and chelation therapy with high serum ferritin wer e investigated with magnetic resonance imaging (MRI). Five children, a ll over 10 years of age, had growth retardation. Gradient recalled ech o sequence was used to highlight any susceptibility effect that could be due to iron in the hypothalamus or pituitary gland. Result: There w as no evidence of abnormal hypointense signal in the hypothalamus or p ituitary gland in the patients studied, regardless of the presence of growth retardation. Conclusion: There was no apparent characteristic M RI appearances of iron deposition in the hypothalamus or pituitary gla nd in thalassaemic children with high serum ferritin.