Thalassemia major-- on the verge of bleeding or thrombosis?

Hematology
Rahul NaithaniVarinder Singh

Abstract

Thrombotic events have been reported in adult thalassemic patients. To investigate this further, we measured hemostatic parameters in thalassemic children to identify possible predisposing factors in early childhood. To assess hemostatic derangements in polytransfused children with beta-thalassemia major (beta-TM). Complete blood count, prothrombin time, activated partial thromboplastin time, protein C, protein S, Antithrombin III (AT III), fibrinogen, d-dimer assay, serum iron, serum ferritin and liver function tests were measured in 54 patients and 30 controls using standard lab methods. Sixteen patients exhibited bleeding manifestations. None of the cases had thromboembolic phenomena. The average pretransfusion haemoglobin in the cases studied was 8.45 +/- 1.6 g/dl, thrombocytopenia was seen in 33.3%, prolongation of prothrombin time was seen in 40.7% and prolongation of aPTT was seen in 46.3%. None of our patients had laboratory features of DIC. Protein C was low in 26.2%, protein S in 28.6% and AT III levels in 46.8% of cases. Mean fibrinogen levels and d-dimers were similar in cases and controls. Serum ferritin levels in the patients were high with a mean of 3,709 +/- 1,625 ng/ml. Serum ferritin had a significant positive...Continue Reading

References

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Citations

Jul 25, 2012·Annals of Hematology·Mehran KarimiEliezer A Rachmilewitz
May 3, 2007·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Rahul NaithaniVed P Choudhary
Mar 10, 2007·Thrombosis Research·Inusha Panigrahi, Sarita Agarwal
Jan 15, 2008·International Journal of Laboratory Hematology·S KashefM A Kashef
Jun 15, 2010·Hematology/oncology and Stem Cell Therapy·Tamer H HassanGhada E Amr
Aug 5, 2016·Indian Journal of Pediatrics·Aruna ChhikaraAnita Nangia
May 16, 2008·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Tansu SipahiNejat Akar
Nov 29, 2014·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Ahmad A HamedManal Hamdy El-Sayed
Mar 10, 2018·Paediatric Anaesthesia·Keila M MaherBrad M Taicher
Feb 11, 2012·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Sezaneh Haghpanah, Mehran Karimi
Jul 31, 2010·Pediatric Hematology and Oncology·Galila M MokhtarManal M Abdel Aziz
Dec 31, 2020·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Nuntouchaporn HutachokSomdet Srichairatanakool

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