Osteochondrodystrophic lesions in chelated thalassemic patients: An histological analysis

Some patients affected by thalassemia major and treated with an iron-chelat ing drug such as deferioxamine can suffer from severe osteochondrodystrophi c lesions of the long bones. These lesions were radiologically and clinical ly evident in 2.8% of the patients we examined over the last 10 years. The aim of our research was to evaluate the morphology and morphometry of five tibial biopsy specimens taken from thalassemic patients with bone lesions a nd two bone biopsy specimens taken from thalassemic patients with no altera tion of the long bones. All the bone samples showed a similar morphostructu re. Abnormal chondrocytes, alteration of cartilage staining pattern, irregu lar columnar cartilage, and lacunae in the cartilaginous tissue were reveal ed histologically. Osteoid thickness was either normal or slightly increase d. Some bone trabeculae had microfractures and some had cartilagineous ease s. In five cases, iron deposition was detectable by Perls' Prussian Blue st aining. It can be concluded that even in patients without radiographic sign s of lesions, seriously damaged columnar cartilage, altered bone mineraliza tion, and microfractures are common.