Correlation of serum ferritin levels with the degree of liver fibrosis in transfusion dependent thalassemia patients using shear wave elastography ultrasonography

Introduction: Thalassemia is a highly prevalent hemoglobinopathy that causes anemia. Transfusion-dependent thalassemia patients require regular blood transfusions, leading to iron overload and the deposition of iron in various organs, including the liver. Accumulation of iron in the liver causes liver fibrosis, which increases the mortality of thalassemia patients. Serum ferritin levels are an indicator of iron overload that correlates with liver iron levels. Ultrasound-based shear wave elastography is a non-invasive modality with good accuracy for assessing the degree of liver fibrosis. The aim of this study is to determine the correlation between serum ferritin levels and the degree of liver fibrosis in thalassemia major patients using ultrasound-based shear wave elastography. Methods: This research is an observational- analytical study with a cross-sectional approach. The data used is secondary data taken from laboratory results and prospective data from ultrasound-based shear wave elastography examinations at Dr. Hasan Sadikin Hospital Bandung from January 2024 to March 2024. The Spearman’s Rank correlation test was carried out to assess the correlation between serum ferritin levels and the degree of liver fibrosis with a confidence level of 95%. Results: The number of subjects who met the inclusion criteria was 60, consisting of 21 (35%) men and 39 (65%) women with an average age of 25 ± 6 years. The mean value of serum ferritin levels was found to be 6894.0 ± 4774.7 ng/ml. A consultant radiologists conduct the ultrasound-based shearwave elastography. The average median value of liver stiffness using shear wave elastography was 12.3 ± 3.6 kPa, and 95% of subjects had significant liver fibrosis. There is a strong positive correlation between serum ferritin levels and the degree of liver fibrosis. (r=0.734, p<0.001) Conclusion: There is a strong correlation between serum ferritin levels and the degree of liver fibrosis in thalassemia major patients using ultrasound-based shear wave elastography at Dr. Hasan Sadikin Hospital Bandung.