Clinical and Metabolic Complications in patients with thalassemia undergoing transfusion therapy.
Metabolic
stunted
thalassemia
undernutrition
Journal
Journal of family medicine and primary care
ISSN: 2249-4863
Titre abrégé: J Family Med Prim Care
Pays: India
ID NLM: 101610082
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
10
01
2019
revised:
14
12
2019
accepted:
31
12
2019
entrez:
23
4
2020
pubmed:
23
4
2020
medline:
23
4
2020
Statut:
epublish
Résumé
The transfusions in patients with thalassemia are a double-edged sword as the patients develop complications due to inadequate transfusions and due to multiple transfusions. These complications vary from metabolic complications such as diabetes mellitus and clinical complications such as growth retardation, transfusion-transmitted infections (TTI), and iron overload. We selected Balasore district in Odisha which is a satellite center of AIIMS Bhubaneshwar and has a huge population of hemoglobinopathy patients especially thalassemia and this district in Odisha lags in terms of healthcare and health awareness. In all, 123 patients with thalassemia major were included in this study for the evaluation of metabolic and clinical complications. Anthropometric measurements such as height and weight with age and gender were used for evaluation of growth parameters as per World Health Organization (WHO) reference data. Children were termed wasted and stunted if the values were below 2 standard deviation of the reference WHO median. Blood samples were collected for TTI status and fasting blood sugar levels. A total of 118 (95.9%) were detected to have under nutrition, 73 (59.3%) of the patients were HCV-positive, and 54 (48.6%) had high fasting blood sugar levels. Based on the HCV status, they were classified as HCV-positive and HCV-negative to compare the anthropometric and growth status in these patients. About 98.6% of the HCV-positive cases were undernutrition and 83.6% were stunted. There is an increasing trend of associated metabolic derangements in patients with thalassemia. The district-level health services have an urgent need for improvement in chelation regimes and screening technologies.
Sections du résumé
BACKGROUND
BACKGROUND
The transfusions in patients with thalassemia are a double-edged sword as the patients develop complications due to inadequate transfusions and due to multiple transfusions. These complications vary from metabolic complications such as diabetes mellitus and clinical complications such as growth retardation, transfusion-transmitted infections (TTI), and iron overload. We selected Balasore district in Odisha which is a satellite center of AIIMS Bhubaneshwar and has a huge population of hemoglobinopathy patients especially thalassemia and this district in Odisha lags in terms of healthcare and health awareness.
MATERIALS AND METHOD
METHODS
In all, 123 patients with thalassemia major were included in this study for the evaluation of metabolic and clinical complications. Anthropometric measurements such as height and weight with age and gender were used for evaluation of growth parameters as per World Health Organization (WHO) reference data. Children were termed wasted and stunted if the values were below 2 standard deviation of the reference WHO median. Blood samples were collected for TTI status and fasting blood sugar levels.
RESULT
RESULTS
A total of 118 (95.9%) were detected to have under nutrition, 73 (59.3%) of the patients were HCV-positive, and 54 (48.6%) had high fasting blood sugar levels. Based on the HCV status, they were classified as HCV-positive and HCV-negative to compare the anthropometric and growth status in these patients. About 98.6% of the HCV-positive cases were undernutrition and 83.6% were stunted.
CONCLUSION
CONCLUSIONS
There is an increasing trend of associated metabolic derangements in patients with thalassemia. The district-level health services have an urgent need for improvement in chelation regimes and screening technologies.
Identifiants
pubmed: 32318453
doi: 10.4103/jfmpc.jfmpc_845_19
pii: JFMPC-9-973
pmc: PMC7113988
doi:
Types de publication
Journal Article
Langues
eng
Pagination
973-977Informations de copyright
Copyright: © Journal of Family Medicine and Primary Care.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Orphanet J Rare Dis. 2017 May 18;12(1):93
pubmed: 28521805
Indian J Hematol Blood Transfus. 2015 Sep;31(3):367-73
pubmed: 26085723
Sultan Qaboos Univ Med J. 2015 Feb;15(1):e46-51
pubmed: 25685385
Blood. 2016 Nov 24;128(21):2580-2582
pubmed: 27737888
Cold Spring Harb Perspect Med. 2013 Feb 01;3(2):a011775
pubmed: 23378598
ISRN Hematol. 2014 Mar 11;2014:745245
pubmed: 24808962
Transfusion. 2009 Nov;49(11):2454-89
pubmed: 19682345
Ann Intern Med. 2003 Feb 4;138(3):256-61
pubmed: 12558376