Complete blood picture with skeletal and visceral changes in patients with thalassemia major

The objective of this to find the prevalence of skeletal and visceral changes in thalassemics and its relationship with variation in blood components.

This is a cross-sectional study conducted in tertiary care hospital in Karachi among patients diagnosed with thalassemia major who require regular blood transfusions.

Among 200 individuals, 95 were females, whereas 105 were males. 96.5% of the study sample showed normocytic normochromic blood picture. Mean pre-transfusion hemoglobin (Hb) for 200 patients was 8.91 g/dl, while the mean post-transfusion Hb was 12.07 g/dl. Among all the variables, some strong predictors of change were age and HbA which were found associated with the development of cardiac change in transfusion-dependent thalassemia patients. Hepatomegaly was observed in 66.5% of the patients while normal liver span was observed in 33.5%. 6% of patients showed evidence of skeletal changes on X-ray. Splenomegaly was observed in 26.5%, while in 4.5% of the patients, spleen was not visualized due to splenectomy. Cardiac involvement was observed in 8% of the patients on T2*magnetic resonance imaging.

Visceral changes particularly hepatomegaly is very common among transfusion-dependent thalassemia patients. Blood studies for Hb and ferritin levels help to detect these changes when conventional investigations are not possible.