Effect of transfusion interval rate on clinical manifestations of patients with beta- thalassemia major and their correlation with some biochemical parameters
karbala journal of pharmaceutical sciences,
2017, Volume 8, Issue 13, Pages 249-257
AbstractBackground: Regular blood transfusions is the commonest form of life-long treatment for patients with beta-thalassemia major but multiple transfusions of blood causes iron overload and resulting in multiple progressive organ damage that later involved endocrine system, heart, and liver.
Objective: This study is aimed to evaluate some clinical manifestations in the adult patients with beta thalassemia major based on interval rate of the blood transfusion and also investigate correlation between clinical status of patients with some biochemical parameters including the level of ferritin, Hb, prolactin, and cortisol.
Methodology: Forty one Iraqi β -thalassemia major (TM) patients (19male and 22 female) are recruited from thalassemia center in Karbala at age of 14-24 years. The frequency of blood transfusion rate, blood groups, spleen status, and HCV infection are recorded from the profile of all patients. The weight and height of patients were measured to calculate body mass index (BMI), while the concentration of Hb, ferritin, cortisol, and prolactin are tested at morning just before blood transfusion session. Patients are grouped according to their transfusion interval rate (TIR) into two groups; short TIR group (˂ 3 weeks), and long TIR group (≥ 3 weeks).
Results: The results were non-significant in the distribution of gender and blood groups, spleen status, frequency of HCV infection, Hb, cortisol, and prolactin between the two groups, but age average, ferritin level and BMI of long TIR group are significantly lower than those of short TIR patients. On the other hand, long TIR patients revealed non-significant correlation between all parameters and clinical manifestations except for Hb content which is significantly decreased (r = - 0.451, P = 0.039) in splenectomized patients. However, short TIR group showed that Hb content is significantly decreased in both splenectomized (r = - 0.560, P = 0.01) and underweighted (r = - 0.477, P = 0.033) TM patients.
Conclusion: We can concluded that the levels of cortisol and prolactin hormones are neither disturbed in TM patients nor correlated with interval rate of transfusion, but Hb level is the key factor that determine TIR and ferritin level leading to retardation in BMI which may be due to another endocrinopathy particularly those that are closely related with metabolic pathways such as growth hormone and thyroxin.
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