Choroid plexus and pituitary gland hemochromatosis induced by transfusional iron overload: Two case reports

Hiroyuki Fujii, MD, PhD; Mitsuru Matsuki, MD, PhD; Takefumi Hamakawa, MD; Yumiko Toda, MD; Nana Fujii, MD; Sota Masuoka, MD; Akihiro Nakamata, MD; Emiko Chiba, MD, PhD; Kazunari Ishii, MD, PhD; Harushi Mori, MD, PhD

Radiology Case Reports (May 2024)

Choroid plexus and pituitary gland hemochromatosis induced by transfusional iron overload: Two case reports

Hiroyuki Fujii, MD, PhD,
Mitsuru Matsuki, MD, PhD,
Takefumi Hamakawa, MD,
Yumiko Toda, MD,
Nana Fujii, MD,
Sota Masuoka, MD,
Akihiro Nakamata, MD,
Emiko Chiba, MD, PhD,
Kazunari Ishii, MD, PhD,
Harushi Mori, MD, PhD

Affiliations

Hiroyuki Fujii, MD, PhD: Department of Radiology, Jichi Medical University, Tochigi, Japan; Corresponding author.
Mitsuru Matsuki, MD, PhD: Department of Pediatric Radiology, Jichi Children's Medical Center Tochigi, Japan
Takefumi Hamakawa, MD: Department of Radiology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
Yumiko Toda, MD: Division of Hematology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
Nana Fujii, MD: Department of Radiology, Jichi Medical University, Tochigi, Japan
Sota Masuoka, MD: Department of Radiology, Jichi Medical University, Tochigi, Japan
Akihiro Nakamata, MD: Department of Radiology, Jichi Medical University, Tochigi, Japan
Emiko Chiba, MD, PhD: Department of Radiology, Jichi Medical University, Tochigi, Japan
Kazunari Ishii, MD, PhD: Department of Radiology, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
Harushi Mori, MD, PhD: Department of Radiology, Jichi Medical University, Tochigi, Japan

Journal volume & issue: Vol. 19, no. 5
pp. 1666 – 1670

Abstract

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Hemochromatosis is a primary or secondary pathological condition characterized by the deposition of excess iron in the body tissues, which can eventually lead to cellular damage and organ dysfunction. Although excess iron deposition in the central nervous system is rare, involvement of the choroid plexus, pituitary gland, cortical surfaces, and basal ganglia has been reported to date. This case report describes 2 cases of transfusion-induced hemochromatosis involving the choroid plexus and pituitary gland, which were diagnosed by magnetic resonance imaging (MRI). In both cases, gradient echo (GRE) sequences, such as T2 star-weighted image and susceptibility-weighted imaging demonstrated markedly low signal intensity in the choroid plexus. Furthermore, the pituitary gland showed low signal intensity on T2-weighted images in Patient 2. Because these low signal intensities were not seen prior to red blood cell transfusion, they were diagnosed with transfusion-induced hemochromatosis. Brain MRI with GRE sequences was useful in detecting iron deposition in the choroid plexus. Considering that iron deposition in the body tissues can lead to irreversible organ damage, MRI with GRE sequences should be considered for patients with suspected iron overload.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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