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"Minor" hemoglobinopathies: a risk factor for asthma.

A G Palma-Carlos1, M Laura Palma-Carlos, Ana Célia Costa

  • 1CAIC--Clinical Allergy-Immunology Center Lisbon, Portugal. a-g-palma-carlos@clix.pt

European Annals of Allergy and Clinical Immunology
|June 30, 2005
PubMed
Summary

Asthma prevalence is higher in patients with thalassemia minor and sickle cell trait. Hemoglobinopathies may contribute to bronchial hyperreactivity, suggesting screening for these conditions in asthmatic patients with microcytosis.

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Area of Science:

  • Hematology
  • Allergology
  • Pulmonology

Background:

  • Hemoglobinopathies like thalassemia and sickle cell disease are prevalent in Portugal and the Mediterranean.
  • Minor, asymptomatic forms (thalassemia minor, sickle cell trait) are common and can cause microcytosis and hemorheologic disturbances.
  • This study investigates the incidence of asthma in patients with hemoglobinopathies who are allergic to house dust mites.

Purpose of the Study:

  • To evaluate the incidence of asthma in patients diagnosed with hemoglobinopathies.
  • To explore the potential link between hemoglobinopathies and allergic respiratory diseases, specifically asthma.
  • To assess the role of house dust mite allergy in this patient population.

Main Methods:

  • A cohort of 63 patients with confirmed hemoglobinopathies was identified from 4,000 out-patients over 5 years.

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  • Patients underwent allergy assessment including skin prick tests, IgE measurements, and respiratory function tests.
  • Hemoglobinopathies were confirmed via red cell count, hemoglobin electrophoresis, and sickle cell testing.

    • Main Results:

    • Among 63 hemoglobinopathy patients, 57 had respiratory allergies. Asthma was diagnosed in 41 (75%) of these, while 14 (25%) had rhinitis.
    • In contrast, a control group of 491 allergic patients without hemoglobinopathies showed asthma in 57% and rhinitis in 43%.
    • The prevalence of asthma was significantly higher in patients with thalassemia minor and sickle cell trait compared to controls (p<0.05).

    Conclusions:

    • Asthma prevalence is significantly higher in individuals with thalassemia minor and sickle cell trait.
    • Hemorheologic changes associated with hemoglobinopathies, such as increased red blood cell rigidity, may influence bronchial circulation and reactivity.
    • Screening for hemoglobinopathies is recommended in asthmatic patients presenting with microcytosis or mild anemia.