Objective To analyze the clinical characteristics of proximal tubular acidosis induced by deferasirox in children with β-thalassemia major. Methods This study retrospectively analyzed the clinical manifestations, laboratory test results, radiological features, treatment methods and outcomes of proximal tubular acidosis in 5 children with β-thalassemia major. Results Five patients aged 5 to 16 years, included 2 males and 3 females. Two patients were diagnosed with Fanconi syndrome. Four patients received deferasirox doses exceeding the conventional dose, including one with a rapid decline in ferritin levels. Gastrointestinal symptoms were the initial manifestations in 3 patients, while only mild anorexia was observed in 2 patients. There were significant correlations between the severity of clinical manifestations, the degree of acidosis and its duration. All patients had abnormally elevated urine β₂-microglobulin levels, and 4 patients had hepatic iron deposition. After reducing or discontinuing deferasirox and providing symptomatic treatment, the renal tubular function of all 5 patients gradually recovered. Conclusion Proximal tubular acidosis induced by deferasirox in patients with β-thalassemia major can manifest as partial or complete proximal tubular acidosis, which may be associated with high-dose deferasirox administration and rapid decreases in body iron levels. Regular monitoring of relevant indicators is recommended for children receiving long-term deferasirox treatment. Once proximal tubular acidosis is detected, drug dosage adjustment or discontinuation should be promptly implemented, and renal tubular function can recover in most patients.

Hepatocellular carcinoma (HCC) is a highly prevalent tumor in China. It has an insidious onset, rapid progression, early recurrence and poor prognosis. Most patients are already in the middle and late stages when they are diagnosed and lose the best time for surgery. Therefore, early diagnosis and treatment of HCC is crucial for patients. In recent years, contrast-enhanced ultrasound (CEUS) technology has been widely used in the diagnosis of liver diseases, especially in the diagnosis and treatment of HCC, which has an irreplaceable role. Meanwhile, the image fusion technology developed on the basis of CEUS can highlight the value of CEUS in the diagnosis and treatment of HCC.