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Transfusional Iron Overload and Choroid Plexus Hemosiderosis in a Pediatric Patient: Brain Magnetic Resonance Imaging Findings

  • Kim, Min Seon (Department of Radiology, Inha University School of Medicine, Inha University Hospital) ;
  • Lee, Ha Young (Department of Radiology, Inha University School of Medicine, Inha University Hospital) ;
  • Lim, Myung Kwan (Department of Radiology, Inha University School of Medicine, Inha University Hospital) ;
  • Kang, Young Hye (Department of Radiology, Inha University School of Medicine, Inha University Hospital) ;
  • Kim, Jun Ho (Department of Radiology, Inha University School of Medicine, Inha University Hospital) ;
  • Lee, Kyung Hee (Department of Radiology, Inha University School of Medicine, Inha University Hospital)
  • Received : 2019.08.31
  • Accepted : 2019.09.23
  • Published : 2019.12.30

Abstract

Hemosiderosis is characterized by the deposition of excess iron in body tissues. The choroid plexus is an important part of the central nervous system that can be the primary site of iron overload. T2*-weighted gradient echo (GRE) sequence provides high sensitivity for demonstrating cerebral microhemorrhagic foci and iron deposition. In the present study, we describe the case of a 15-year-old boy with acute lymphoblastic leukemia, in whom repeated transfusion led to iron accumulation in the brain. GRE sequence effectively demonstrated hemosiderin deposition in the choroid plexus.

Keywords

References

  1. Fleming RE, Ponka P. Iron overload in human disease. N Engl J Med 2012;366:348-359 https://doi.org/10.1056/NEJMra1004967
  2. Morris CM, Keith AB, Edwardson JA, Pullen RG. Uptake and distribution of iron and transferrin in the adult rat brain. J Neurochem 1992;59:300-306 https://doi.org/10.1111/j.1471-4159.1992.tb08904.x
  3. Rouault TA, Zhang DL, Jeong SY. Brain iron homeostasis, the choroid plexus, and localization of iron transport proteins. Metab Brain Dis 2009;24:673-684 https://doi.org/10.1007/s11011-009-9169-y
  4. Duprez T, Maiter D, Cosnard G. Transfusional hemochromatosis of the choroid plexus in beta-thalassemia major. J Comput Assist Tomogr 2001;25:487-488 https://doi.org/10.1097/00004728-200105000-00025
  5. Sossa DE, Chiang F, Verde AR, Sossa DG, Castillo M. Transfusional iron overload presenting as choroid plexus hemosiderosis. JBR-BTR 2013;96:391
  6. Kira R, Ohga S, Takada H, Gondo K, Mihara F, Hara T. MR choroid plexus sign of iron overload. Neurology 2000;55:1340 https://doi.org/10.1212/WNL.55.9.1340
  7. Fearnley JM, Stevens JM, Rudge P. Superficial siderosis of the central nervous system. Brain 1995;118 (Pt 4):1051-1066 https://doi.org/10.1093/brain/118.4.1051
  8. Eng J, Fish JD. Insidious iron burden in pediatric patients with acute lymphoblastic leukemia. Pediatr Blood Cancer 2011;56:368-371 https://doi.org/10.1002/pbc.22851
  9. Halonen P, Mattila J, Suominen P, Ruuska T, Salo MK, Makipernaa A. Iron overload in children who are treated for acute lymphoblastic leukemia estimated by liver siderosis and serum iron parameters. Pediatrics 2003;111:91-96 https://doi.org/10.1542/peds.111.1.91
  10. Haacke EM, DelProposto ZS, Chaturvedi S, et al. Imaging cerebral amyloid angiopathy with susceptibility-weighted imaging. AJNR Am J Neuroradiol 2007;28:316-317