Iron status of beta thalassemia carriers

Abstract

One hundred twenty-four relatives (aged 17-52 years) of 35 children with severe transfusion-dependent beta thalassemia major were investigated for their beta thalassemia carrier status (determined by Hb-A2 level) and iron status (determined by serum ferritin level). Forty-eight males had beta thalassemia trait (BTT) and 18 males did not have BTT (control); 41 females had BTT and 17 females did not have BTT (control). Serum ferritin levels (mean +/- SEM) of male BTT, male control, female BTT, and female control groups were 151.0 +/- 27.4, 59.6 +/- 16.3, 120.6 +/- 36.6, and 17.2 +/- 6.1 mcg/liter respectively; the differences between the two male and the two female groups were statistically significant (p = .05 and p less than .001). Iron deficiency (serum ferritin below 10.0 mcg/liter) was present in 6.3%, 38.9%, 24.4%, and 58.8% of male BTT, male control Female BTT, and female control groups, respectively; the differences between the two male and two female groups were statistically significant (p less than .01 and p less than .01). Serum ferritin was over 1,000 mcg/liter in four individuals with BTT (2 male and 2 female). Thus, the BTT group had better iron nutrition. This may suggest that the BTT group has an advantage in maintaining iron balance.

Prevalence of Iron Deficiency in Thalassemia Trait: A study in BSMMU, Dhaka

“…This finding of the present study is also consistent with other study which was carried out on British Asian children 13,14 . The co-existence might be due to different gastrointestinal disorders, chronic blood loss due to different helminthes infestation which is very common in Bangladesh.…”

Phenotypic expression of hemoglobin A 2 in beta-thalassemia trait with iron deficiency

“…The prevalence has been reported to vary between 17 and 47% in other studies [1,8,12,22]. This suggests that iron deficiency is not less common among heterozygous beta-thalassemics than among the general population of this region of India, and it should not be presumed that the trait confers an advantage in maintaining iron balance, as has been reported earlier [13]. The effect of iron deficiency in BTT manifested as a significant (p~0001) lowering of Hb concentration and an increased prevalence of anemia.…”

Prevalance of Iron Deficiency in Thalassemia Minor: A Study from Tertiary Hospital

“…which showed that iron deficiency was a common finding in female TT of reproductive age not receiving iron supplementation. However in 1987 BC Mehta and BG Pandya examined 124 relatives of children receiving blood transfusion for thalassemia major, both with beta TT and without it (control), and showed that the BTT group had an advantage in maintaining iron balance [4]. A study for the frequency of coincident iron deficiency and beta TT in British Asian children was done in 1995 that showed that the two can coexist and are mutually exclusive at least in the early years [8].…”

“…Hb A2 level 4.0-10.0% along with low MCV (\80 fl), low MCH (\27 pg) are the criteria used for the diagnosis of TT and serum ferritin level B15 ng/ml diagnosed as IDA [4]. Patients suffering from fever clinically suspected inflammatory disorders and other haemoglobinopathies were excluded from study.…”

“…Thalassemia trait (TT) is a carrier state in which only one allele is mutated. It has been believed that TT confers advantage in iron balance [3][4][5]. Because the signs of iron deficiency resembles as that of any anemia and the blood picture largely that of TT itself, the simultaneous prevalence of iron deficiency in these people is often overlooked.…”