Evaluation of Respiratory Problems in Patients With β Thalassemia

Thalassemia is a hereditary anemia with treatment of lifelong blood transfusion. Iron overload in vital organs is the consequence of this treatment. According to recent studies Iron could deposit in lung without causing any symptoms and signs in the patients. Our goal in this study was to evaluate the pulmonary abnormalities by Pulmonary function test (PFT) in patients with β- thalassemia. Patients and In this descriptive study 139 patients with β thalassemia were evaluated. History was obtained in regard to blood transfusion and clinical features. Physical examination, chestX ray, ABG and pulmonary function tests (PFT) were performed. Results were analyzed by SPSS software V. 11.5 and Chi square test. 139 patients were enrolled in this study there were 85 (62%) males and 54 (38%) females. Meanwhile 104 Patients (75%) had thalassemia major and 35 (25%) had thalassemia intermedia. Mean age was 21.1 yr and mean duration of treatment was 18 yr. In history of 128 (95.5%) patients, no respiratory problem was noticed. Chest X- ray was done for 112 patients 100 (89.2%) had normal pattern while 12 (10.7%) patients had abnormal patterns on their chest x- rays. In ABG, mean PO2 was 73.5% and mean O2 saturation was 90.6%. Mean ferritin level was 1800 ng/dl. According to PFT results 101 patients (72.7%) had restrictive patterns, 35 patients (25.1%) had normal pattern and 3 (2.2%) had combined pattern. There was significant between PFT results and duration of blood transfusion (Pvalue = 0.05). However there was negative statistical correlation between PFT results and ferritin (Pvalue = 0.62). In our results restrictive pattern was the most common finding(72.7%) in PFT 95% of patients did not have any respiratory complaints and on chest x- ray 89% had normal pattern. Thus lung can be considered as a site for iron deposition during blood transfusion. However despite PFT abnormalities, clinical features are not demonstrated in thalassemic patients because of the high lung capacity / reserves. A healthy lung cannot be assurred by a single physical examination and negative history. Thus, in addition to well chelation, PFT must be performed in patients in order to prevent from any respiratory disorder at the older ages.