Role of Transient Elastography in Pediatric Transfusion Dependent Thalassemia Patients from Lower Socioeconomic Strata and its Correlation with Serum Ferritin: A Cross-Sectional Study.

Thalassemia is a very common single gene disorder worldwide. They regularly require blood transfusions resulting in excessive accumulation of iron in various organs. The liver is the first organ to accumulate iron and this excessive iron leads to hepatic fibrosis. Data regarding prevalence of hepatic fibrosis in children is lacking. Transient elastography (TE) is a recent non-invasive test to estimate liver-stiffness. Its role in children with thalassemia has not been fully investigated. We aimed to see the prevalence of hepatic fibrosis in transfusion dependent thalassemia (TDT) patients belonging to lower socioeconomic-strata and correlate the degree of hepatic fibrosis with serum ferritin. This cross-sectional study was conducted in July 2023 in tertiary care hospital in TDT children from lower socio-economic strata, aged 3-13 years who were negative for Hepatitis C and B. Blood investigations and TE were conducted in all the included patients and statistical analysis was done. 45 patients fulfilled inclusion and exclusion criteria. Mean age was 6 years, Mean serum ferritin was 2010.2 ng/ml, mean Liver stiffness Measurement (LSM) score was 9.25 kPa. 51.1% of study subjects had varying degree of hepatic fibrosis. We found significant positive correlation between serum ferritin and LSM score. We conclude that prevalence of hepatic fibrosis is high in TDT children and TE can be used to monitor hepatic fibrosis in this vulnerable group of patients.