Transfusional Iron Overload- A Major Issue in Multi - Transfused Beta Thalassemia Patients
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 379-386
AbstractIntroduction: In β-thalassaemia major, repeated blood transfusions, ineffective erythropoiesis and increased gastrointestinal iron absorption lead to iron overload in the body. In developing countries like India with limited availability there is still reliance on the serum ferritin level as a means of monitoring the iron overload and the efficacy of chelation.
Objective: The aim of the study was to measure the ferritin levels in multi-transfused β-thalassemia major as an indicator of transfusional iron overload. To study the association of serum ferritin level with various variable, complications due to repeated transfusion, compliance of patients to iron chelation therapy.
Materials And Methods: A total of 60 β-thalassemia Major patients registered at the tertiary care centre for blood transfusion who received more than 10 units of blood transfusion were included in this cross sectional study. Parameters studied were serum ferritin level, seroconversion for transfusion transmitted infections and complications such as deranged thyroid function test, liver function test and cardiac function.
Results: The mean serum ferritin levels were 3801+/- 1675.20. 77.35% (41/53) were compliant to the iron chelation therapy. The mean ferritin levels in compliant versus non compliant patient was 3773.87 ng/ml and 3695.05 ng/ml. The thyroid function test was abnormal in 9.43 % (5/53), Liver function test was deranged in 49.12% (28/57) and 2D Echo for heart function was abnormal in 14.28% (3/21) patient. 2 patients (3.33%) were sero-positive, one for HCV and second for HIV antibody.
Conclusion: There is a need for better quantitative indicators, non-invasive methods, accurate and which are readily available along with development of newer chelating agent for better compliance and efficacy. Antenatal diagnosis, increase awareness among patient and relative, adequate provision of medical care facility, adherence to standard treatment protocol and Bone Marrow Transplant may result in effective management of the thalassemia patient.
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