IRON OVER LOAD AND ITS RELATION WITH HAEMOSTATIC PARAMETERS IN BETA-THALASSEMIA PATIENTS

Authors

  • Saima Pervaiz Department of Immunology (Pathology), University of Health Sciences, Lahore, Pakistan
  • Aliya Aslam Department of Pathology, Azra Naheed Medical College, Lahore, Pakistan
  • Saima Irum Department of Pathology, Azra Naheed Medical College, Lahore, Pakistan
  • Fauzia Khan Department of Pathology, DHQ Hospital, Rawalpindi, Pakistan
  • Sadia Haleema Department of Biochemistry, Continental Medical College, Lahore, Pakistan
  • Asma Arshad Department of Biochemistry, Continental Medical College, Lahore, Pakistan
  • Isra Khalid Rana Medical Officer, Punjab Health Department, Pakistan
  • Saba Shamim Institute of Molecular Biology and Biotechnology, University of Lahore, Pakistan

DOI:

https://doi.org/10.69656/pjp.v20i3.1742

Keywords:

Thalassemia, Bleeding, Hemostasis, Anticoagulants, Thrombocytopenia

Abstract

Background: Patients with beta-thalassemia major have been observed to experience changes in their coagulation profile. These changes include an elongated prothrombin time and partial thromboplastin time as well as bring down levels of natural anticoagulants and coagulation factors. The mechanisms underlying the occurrence of thrombotic tendencies in some thalassemia patients remain unclear. This study aims to examine the alterations in the iron and coagulation profile among beta-thalassemia patients. Methods: After informed consent, 50 children having beta-thalassemia, and 50 healthy controls were included in this study. Blood samples were collected and serum ferritin, haematological and haemostatic parameters were measured. Data was analysed on SPSS-24. Results: The laboratory assessment revealed 43.5% of the patients had thrombocytopenia, 54% had prolonged prothrombin time (PT), and 56% of the patients had prolonged activated partial thromboplastin time (aPTT). All estimated coagulation factors exhibited lower activity levels in comparison to the control group. Serum ferritin exhibited a positive relationship with PT and aPTT and a substantial negative relationship with total platelet count. Conclusion: High serum ferritin levels are associated to abnormal haemostatic parameters in thalassemia patients. Regular monitoring of serum ferritin levels is essential to ensure that thalassemia patients receive appropriate treatment and support.

Pak J Physiol 2024;20(3):71–3, DOI: https://doi.org/10.69656/pjp.v20i3.1742

Downloads

Download data is not yet available.

References

John TD, Namazzi R, Chirande L, Tubman VN. Global perspectives on cellular therapy for children with sickle cell disease. Cur Opin Hematol 2022;29(6):275–80.

Abdallah AM. Thalassemia and pregnancy complications. World J Adv Res Rev 2022;14(1):363–7.

Alwataify AS, Alshammary HN, Mahdi AH. Portal vein thrombosis in patients with ?-Thalassemia. In: Rajashekaraiah N, (Ed).The Erythrocyte –A Unique Cell. IntechOpen; 2022.

Bellis G, Parant A. Beta-thalassemia in Mediterranean countries. Findings and outlook. Investig Geog 2022;77:129–38.

Naithani R, Chandra J, Narayan S, Sharma S, Singh V. Thalassemia major - on the verge of bleeding or thrombosis? Hematology 2006;11(1):57–61.

Maiti A, Chakraborti A, Chakraborty P, Mishra S. Subclinical haemorrhagic tendency exists in patients with ?-thalassaemia major in early childhood. Australas Med J 2012;5(2):152–5.

Singh S, Yadav G, Kushwaha R, Jain M, Ali W, Verma N, et al. Bleeding versus thrombotic tendency in young children with beta-thalassemia major. Cureus 2021;13(12):e20192.

Rivella S. Iron metabolism under conditions of ineffective erythropoiesis in ?-thalassemia. Blood 2019;133(1):51–8.

Situmorang E, Aman AK, Lubis B. Coagulation defects in beta-thalassemia major patients at Haji Adam Malik Hospital Medan. Bali Med J 2019;8(2):501–4.

Cappellini MD, Galanello R, Piga A, Cohen A, Kattamis A, Aydinok Y, et al. Effcacy and safety of deferasirox (Exjade®) with up to 4.5 years of treatment in patients with thalassemia major: a pooled analysis. Blood 2008;112(11):5411.

Marwaha RK, Hafis-Ibrahim CP, Marwaha N. Haemostatic derangements and lupus anticoagulant in polytransfused patients with beta thalassemia. Pediatr Res 1999;45(Suppl 5):760.

Shabbir A, Farhan S, Rehman AU, Mazhar N, Hareem S, Iqbal I. Coagulation abnormalities in pediatric patients with ?-thalassemia, an experience at a tertiary care hospital: coagulation abnormalities in pediatric patients. Pak Biomed J 2023;6(9):25–8.

Harish GV, Pasha SJ. Correlation of serum ferritin levels with liver function tests and anthropometric measurements in transfusion dependent beta-thalassemia major children: a cross sectional study. Pediatr Oncall J 2019;16(4):101–4.

Lardinois B, Hardy M, Michaux I, Horlait G, Rotens T, Jacqmin H, et al. Monitoring of unfractionated heparin therapy in the intensive care unit using a point-of-care aPTT: A comparative, longitudinal observational study with laboratory-based aPTT and anti-Xa activity measurement. J Clin Med 2022;11(5):1338.

Zermatten MG, Fraga M, Calderara DB, Aliotta A, Moradpour D, Alberio L. Biomarkers of liver dysfunction correlate with a prothrombotic and not with a prohaemorrhagic profile in patients with cirrhosis. JHEP Rep 2020;2(4):100120.

Darvishi-Khezri H, Salehifar E, Kosaryan M, Karami H, Alipour A, Shaki F, et al. The impact of silymarin on antioxidant and oxidative status in patients with ?-thalassemia major: A crossover, randomized controlled trial. Complement Ther Med 2017;35:25–32.

Wadaha HA, Meshay HD, Khamees MH. Changes in coagulation status in patients with ?-thalassemia in Iraq: A case-control study. Med J Babylon 2022;19(2):157–61.

Faranoush M, Faranoush P, Heydari I, Foroughi?Gilvaee MR, Azarkeivan A, Parsai Kia A, et al. Complications in patients with transfusion dependent thalassemia: A descriptive cross?sectional study. Health Sci Rep 2023;6(10):e1624.

Kattamis A, Kwiatkowski JL, Aydinok Y. Thalassaemia. Lancet 2022;399(10343):2310–24.

Downloads

Published

30-09-2024

How to Cite

1.
Saima Pervaiz, Aslam A, Irum S, Khan F, Haleema S, Arshad A, et al. IRON OVER LOAD AND ITS RELATION WITH HAEMOSTATIC PARAMETERS IN BETA-THALASSEMIA PATIENTS. Pak J Phsyiol [Internet]. 2024 Sep. 30 [cited 2024 Oct. 16];20(3):71-3. Available from: https://pjp.pps.org.pk/index.php/PJP/article/view/1742