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Investigation of polyneuropathy in transfusion-dependent thalassemia
Deniz Kamaci Sener1, Sevil Sadri2, Vildan Gursoy2, Ozden Kamisli11Department Of Neurology Bursa City Hospital, Bursa, Türkiye2Department Of Haematology Bursa City Hospital. Bursa, Türkiye
INTRODUCTION: Transfusion-dependent thalassemia patients neurological complications remained subclinical and were demonstrated only during neuropsychological, neurophysiological, or neuroimaging evaluation. The aim of this study was to investigate the incidence of peripheral and entrapment neuropathies in a patient group and determine whether these neurological complications correlate with liver and heart involvement.
METHODS: The study included 28 patients with transfusion-dependent thalassemia and 32 healthy controls. Nerve conduction studies were performed in the upper and lower extremities and the findings were evaluated in terms of entrapment neuropathy and polyneuropathy. Demographic data, laboratory parameters, radiological images of the patients were compared with the nerve conduction findings.
RESULTS: In the patient group, 64.29% had polyneuropathy, 10.71% had carpal tunnel syndrome, and 3.5% had ulnar neuropathy at elbow. Polyneuropathy was significantly more prevalent in the patient group. No correlation was found between polyneuropathy and age, gender, splenectomy, or ferritin. Hemoglobin was positively correlated with sural amplitude and tibialis amplitude. Liver MR T2 sequence was negatively correlated with PNP, ulnar sensory latency and was positively correlated with ulnar sensory amplitude, ulnar sensory velocity. We didn’t find relationship between heart MRI T2* and nerve conduction study.
DISCUSSION AND CONCLUSION: The findings obtained in the present study indicate that in patients with transfusion-dependent thalassemia, PNP is associated with iron overload in tissues. Furthermore, neurologic complications may be associated with other organ involvement.
Manuscript Language: English