Comparison of Iron Load of the Liver and Gum of Patients with Thalassemia Major.

Various researchs have being conducted to replace liver biopsy which is accepted as a gold standart to evaluate prognosis and as the best indicator of total body iron storage in thalassemia major cases. Especially liver and heart iron storages determined by MR have been reported to correlate with tissue iron leves. However, these techniques have not been investigated sufficiently. We haven’t encountered any study comparing histopathological evaluation of gum and liver iron storage as an indicator of body iron storage. Therefore we have aimed to investigate and compare gum and liver iron storages by histological method which is techniqually easier and lesser noninvasive method. For this purpose, totally 22 beta thalassemia major, aged beetween 5–18 years, were investigated. As control group, 20 healthy person who experienced a tooth extraction, aged between 5–18 years, were included to study. Both gum and liver biopsies of the patients and only gum biopsies of controls were performed. Biopsy samples were stained with Prussia blue, hematoxyleneosin and Masson trichrome dyes. Collagen type-I and type-II were evaluated by immunohistochemical staining. Results; in all thalassemics, siderosis, fibrosis and hepatitis were found in hepatocellular, kupffer and portal areas. Iron in arteriolar wall and endotelium was seen in 22,7% and 50% of cases, respectively. Collagen type-I was found in 54,5% of cases. A statistically significant correlation was found between liver fibrosis, siderosis and iron overload but there was no significant correlation between liver and gum as fibrosis and siderosis in thalassemics. As a result, although periodontological and gingival problems in thalassemics were significantly important to the controls as clinically and histopatologically, however, there was no significant correlation between gum siderosis and hepatocellular siderosis as an indicator of body iron storage in thalassemic patients.