Thalassemia Major Clinical Trial
Official title:
Evaluation of Nutritional Status in Patients With Thalassemia Major in Assiut University Children Hospital
Thalassemia is a blood disorder passed down through families in which the body makes an
abnormal form of hemoglobin. There are 2 main types of thalassemia; Alpha & Beta thalassemia.
Alpha thalassemia: occurs when a gene or genes related to the alpha globin protein are
missing or mutated.
Beta-thalassemia syndromes are a group of hereditary blood disorders characterized by reduced
or absent beta globin chain synthesis. Beta-thalassemias can be classified into:
Silent carrier: completely asymptomatic with normal hematological parameters.
Beta-thalassaemia minor (beta-thalassaemia trait): usually asymptomatic; diagnosis is made
during a work-up for mild anemia.
Beta-thalassaemia intermedia: usually a similar presentation to beta-thalassaemia major;
symptoms are usually less pronounced and the course is usually more insidious.
Beta-thalassaemia major : In which there is complete absence of hemoglobin A
In Egypt beta thalassemia-major is the most common type with carrier rate of 5.3 to ≥9%and
1000 new cases born with beta-thalassemia major per 1.5 million live births per year.
Children born with thalassemia major are normal at birth, but develop severe hemolytic anemia
during the first year of life. Symptoms are those of anemia (lethargy, poor feeding,
pallor…etc.) failure to thrive and organomegaly. Later on they develop signs of extra
medullary hematopoiesis .
Optimal nutritional status is important for growth, immune function, bone health and pubertal
development . Various reports suggest the incidence of poor growth ranges from 25% to 75%
depending on thalassemia syndrome and severity of disease. This marked growth deficits raise
a red flag for any pediatrician to evaluate nutritional status of thalassemic patients and
detect possible nutritional deficiencies and associated factors.
Etiology of delayed growth and malnutrition reported in thalassemic patient is multifactorial
including :
1. Nutritional deprivation with or without feeding difficulties arising from fatigue and
breathlessness
2. Increased energy expenditure secondary to hyper metabolism with or without heart failure
3. Gastrointestinal hypoxia which consequently produces anorexia and malabsorption
4. Reduction of biosynthetic activity of liver.
5. Disturbance of the endocrine function
6. Impaired synthetic hepatic function secondary to hemosiderosis and hepatitis.
The main aim of this study is to assess the nutritional status of thalassemic patient
attending Assiut university Children hospital and to determine the factors involved.
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