Original Article
 
Iron overload in beta thalassemia major patients
Atthanayaka Mudiyanselage Dilhara Sewwandi Karunaratna1, JG Shirani Ranasingha2, Rasnayaka Mudiyanselage Mudiyanse3
1BVSc, Postgraduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka
2PhD, Professor, Postgraduate Institute of Science, University of Peradeniya, Peradeniya, Sri Lanka
3MD, Professor in Pediatrics, Department of Pediatrics, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka

Article ID: 100032IJBTIAK2017
doi:10.5348/ijbti-2017-32-OA-5

Address correspondence to:
JG Shirani Ranasingha
Head of Department, Department of Biochemistry
Faculty of Medicine, University of Peradeniya
Peradeniya
Sri Lanka

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How to cite this article
Karunaratna AMDS, Ranasingha JGS, Mudiyanse RM. Iron overload in beta thalassemia major patients. Int J Blood Transfus Immunohematol 2017;7:33–40.



Abstract

Aims: Beta thalassemia is the most common monogenic hereditary hemoglobin disorder, which poses a major health burden to Sri-Lanka. Regular transfusions of erythrocytes required for survival of these patients lead to inevitable iron overload, which is manifested, by elevated serum ferritin levels. Progressive deposition of iron leads to dysfunction and failure of the major organs. The aim of this study was to evaluate the iron overload of the beta thalassemia major patients in one of the thalassemia centres in Sri Lanka and to find its effect on growth status of the patients.
Methods: The study included forty patients with confirmed diagnosis of beta thalassemia major, undergoing any chelation treatment. The mean age of the study group was 10.97±5.9 years with a range of 2–20 years. The patients were interviewed for the socio-demographic variables and their medical histories were obtained from the hospital files. Serum ferritin concentration, height and weight of the patients were measured and body mass index (BMI) was calculated.
Results: The mean serum ferritin concentration was 2992.2±1575.35 ng/ml which showed a significant correlation with age and duration of blood transfusion. The mean z-score for height was -2.3±1.06 and 50% of the patients were stunted. The mean z-score for BMI was -1.32±1.28 and 35% of the patients were wasted. Both height and BMI had no significant correlation with iron overload of the patients.
Conclusion: Iron overload and growth retardation were common in beta thalassemia major patients of the treatment center evaluated in this study in Sri Lanka. However, there was no significant relationship between physical growth and iron overload.

Keywords: Beta thalassemia major, Growth status, Iron overload


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Acknowledgements
We would like to thank Mr. JMNS Nawaratna, Mr. CN Perera and Mrs. PC Rajakaruna for their assistance in sample collection and laboratory analysis. Moreover, our thanks go to director and staff members of the Peradeniya Teaching Hospital.

Author Contributions
Atthanayaka Mudiyanselage Dilhara Sewwandi Karunaratna – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
JG Shirani Ranasingha – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Rasnayaka Mudiyanselage Mudiyanse – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Atthanayaka Mudiyanselage Dilhara Sewwandi Karunaratna et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.