Recommended strategies for assessment and follow up of iron overload and its related complications
| . | TDT . | NTDT . |
|---|---|---|
| Baseline | Serum ferritin | Serum ferritin |
| Liver MRI for LIC | Liver MRI for LIC | |
| Cardiac T2* MRI | Echocardiography | |
| Echocardiography | Bone mass densitometry | |
| Bone mass densitometry | Testing for endocrinopathy (free T4, TSH, calcium, phosphate, 25-OH vitamin D, FBS) | |
| Testing for endocrinopathy (free T4, TSH, calcium, phosphate, 25-OH vitamin D, FBS) | ||
| Every 3 mo | Serum ferritin | Serum ferritin |
| Safety labs for ICT monitoring | Safety labs for ICT monitoring | |
| Yearly | Serum ferritin | Serum ferritin |
| Liver MRI for LIC* | Liver MRI for LIC* | |
| Cardiac T2* MRI† | Echocardiography | |
| Echocardiography | Bone mass densitometry | |
| Bone mass densitometry | Testing for endocrinopathy (free T4, TSH, calcium, phosphate, 25-OH vitamin D, FBS) | |
| Testing for endocrinopathy (free T4, TSH, calcium, phosphate, 25-OH vitamin D, FBS) |
| . | TDT . | NTDT . |
|---|---|---|
| Baseline | Serum ferritin | Serum ferritin |
| Liver MRI for LIC | Liver MRI for LIC | |
| Cardiac T2* MRI | Echocardiography | |
| Echocardiography | Bone mass densitometry | |
| Bone mass densitometry | Testing for endocrinopathy (free T4, TSH, calcium, phosphate, 25-OH vitamin D, FBS) | |
| Testing for endocrinopathy (free T4, TSH, calcium, phosphate, 25-OH vitamin D, FBS) | ||
| Every 3 mo | Serum ferritin | Serum ferritin |
| Safety labs for ICT monitoring | Safety labs for ICT monitoring | |
| Yearly | Serum ferritin | Serum ferritin |
| Liver MRI for LIC* | Liver MRI for LIC* | |
| Cardiac T2* MRI† | Echocardiography | |
| Echocardiography | Bone mass densitometry | |
| Bone mass densitometry | Testing for endocrinopathy (free T4, TSH, calcium, phosphate, 25-OH vitamin D, FBS) | |
| Testing for endocrinopathy (free T4, TSH, calcium, phosphate, 25-OH vitamin D, FBS) |
FBS, fasting blood sugar; TSH, thyroid-stimulating hormone.
If LIC is normal, MRI can be spaced out in frequency to every 2 years; if LIC >15 mg/g dw, consider repeating MRI more frequently (every 6 months).
If T2* <10 ms or if cardiac dysfunction is present, consider repeating MRI more frequently (every 6 months).