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Thalassemia, Pediatric

Irina B. Pateva, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Thalassemia syndromes are hereditary microcytic anemias that result from mutations that quantitatively reduce globin synthesis.

  • Normal hemoglobin (Hb) is a tetramer of 2 α and 2 β cha...

DIAGNOSIS

HISTORY

  • Severe α-thalassemia (4 gene deletion) presents prenatally by ultrasound or at birth with hydrops fetalis and severe anemia.

  • Severe β-thalassemia usually presents between 3 and 12 mont...

TREATMENT

  • Silent carriers (single α gene deletion) and α- and β-thalassemia trait

    • Genetic counseling only

    • Distinguish from iron deficiency microcytosis to avoid excess iron supplementation

  • For HbH diseas...

ONGOING CARE

For patients with thalassemia major and intermedia: 
  • Serum ferritin and liver function tests should be monitored.

  • Close monitoring of kidney function is necessary as some chelating agents a...

ADDITIONAL READING

  • de Dreuzy E, Bhukhai K, Leboulch P, et al. Current and future alternative therapies for beta-thalassemia major. Biomed J.  2016;39(1):24–38. [View Abstract on OvidInsights]

  • Higg...

CODES

ICD9

  • 282.40 Thalassemia, unspecified

  • 282.43 Alpha thalassemia

  • 282.44 Beta thalassemia

ICD10

  • D56.9 Thalassemia, unspecified

  • D56.0 Alpha thalassemia

  • D56.1 Beta thalassemia

SNOMED

  • 40108008 Thalassemia (diso...

FAQ

  • Q: Is prenatal testing available?

  • A: Yes.

  • Q: In a transfused patient, when does iron overload become a problem and when is chelation started?

  • A: Usually after the age of 3 to 4 years

  • Q: At what age sh...

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