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Use of Serum Ferritin and Age to Evaluation a Patient with Transfusion-Dependent Thalassemia for Iron Overload

Description

Kurban et al used serum ferritin and age to evaluate a patient with transfusion-dependent thalassemia for iron overload. These can help to identify a patient who may require a more thorough evaluation. The authors are from Tawam Hospital, Fatima College of Health Sciences and United Arab Emirates University in the United Arab Emirates.


Patient selection: transfusion-dependent thalassemia

 

Parameters:

(1) serum ferritin in ng/mL

(2) age in years

 

Serum Ferritin

Hepatic Iron Overload

< 700

exclude mild

700 to 1,249

exclude moderate or more; cannot exclude mild

1,250 to 1,649

indeterminate

>= 1,650

seen in mild or more

>= 2,150

seen in moderate or more

 

Myocardial iron overload used the logarithm of age times serum ferritin. It is assumed (based on usage) that this refers to LOG10.

 

LOG10(age * ferritin)

Myocardial Iron Overload

< 4.15

excluded (LR 0.1)

4.15 to 4.64

possible

>= 4.65

likely (LR 3.2)

 

 

Parameter

Points

age in years

0.062 * (age)

serum ferritin in ng/mL

0.001 * (ferritin)

 

value of X =

= SUM(points for both parameter) - 3.781

 

probability of myocardial iron overload =

= 1 / (1 + EXP((-1) * X))

 

Performance:

• The log expression had an area under the ROC curve of 0.78.


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