Clinical and Metabolic Complications in patients with thalassemia undergoing transfusion therapy

BACKGROUND: The transfusions in patients with thalassemia are a double-edged sword as the patients develop complications due to inadequate transfusions and due to multiple transfusions. These complications vary from metabolic complications such as diabetes mellitus and clinical complications such as growth retardation, transfusion-transmitted infections (TTI), and iron overload. We selected Balasore district in Odisha which is a satellite center of AIIMS Bhubaneshwar and has a huge population of hemoglobinopathy patients especially thalassemia and this district in Odisha lags in terms of healthcare and health awareness. MATERIALS AND METHOD: In all, 123 patients with thalassemia major were included in this study for the evaluation of metabolic and clinical complications. Anthropometric measurements such as height and weight with age and gender were used for evaluation of growth parameters as per World Health Organization (WHO) reference data. Children were termed wasted and stunted if the values were below 2 standard deviation of the reference WHO median. Blood samples were collected for TTI status and fasting blood sugar levels. RESULT: A total of 118 (95.9%) were detected to have under nutrition, 73 (59.3%) of the patients were HCV-positive, and 54 (48.6%) had high fasting blood sugar levels. Based on the HCV status, they were classified as HCV-positive and HCV-negative to compare the anthropometric and growth status in these patients. About 98.6% of the HCV-positive cases were undernutrition and 83.6% were stunted. CONCLUSION: There is an increasing trend of associated metabolic derangements in patients with thalassemia. The district-level health services have an urgent need for improvement in chelation regimes and screening technologies.