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Abstract
The incidence of hepatocellular carcinoma (HCC) in patients with thalassemia is increasing, the two well recognized HCC risk factors in thalassemia being iron overload and chronic hepatitis C. The carcinogenicity of iron is related to its induction of oxidative damage, whereas chronic hepatitis leads to necroinflammation that can accelerate progression to HCC. We hereby report the case of a non transfused, hepatitis C-negative, β-thalassemia intermedia (β-TI) patient from our practice who had evidence of significant iron overload, suggesting the importance of increased iron burden as a HCC risk factor in this patient population. As such, screening thalassemia patients using magnetic resonance imaging (MRI)-based liver iron concentration (LIC) measurement and liver ultrasound is strongly recommended for early detection of iron overload and HCC, respectively. Data appears to be lacking on HCC treatment outcomes in patients who have thalassemia, but an approach tailored to each patient’s comorbidities is key to treatment success. The prognosis of these patients can be improved by multicenter studies investigating novel HCC therapeutic targets in the thalassemia realm.
Acknowledgments
This research activity is exempt from institutional review board approval at the American University of Beirut, Beirut, Lebanon and the Chronic Care Center, Hazmieh, Lebanon. Author contributions: Moukhadder HM wrote the letter and performed research. Roumi JE and Bou-Fakhredin R performed research and edited the letter. Taher AT critically reviewed the manuscript and supervised the whole study. All authors read and approved the final draft.
Disclosure statement
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.