Beta thalassemia minor trait clinically asymptomatic. Better differential diagnosis of iron deficiency anemia. Pdf better differential diagnosis of iron deficiency anemia from. Hemoglobin is the protein molecule in red blood cells that carries oxygen. There are many formulas or indices that can discriminate.
However, both alpha and beta thalassemia trait cause microcytic, hypochromic anaemia and are commonly. Anyone can be a carrier of thalassaemia, but its much more common in people from certain ethnic backgrounds. The most severe form of alpha thalassemia is called alpha thalassemia major or hydrops fetalis. Nia, who has beta thalassemia trait, and kiano, who has sickle cell trait, have been married for 10 years and have three children. Thalassemia is the result of an imbalance in the two globin chains that produce the hemoglobin molecule. Microcytic anemia can be caused by iron deficiency, thalassemia, lead. In this type, the lack of beta protein causes no problems in the normal functioning of the hemoglobin. Hemoglobinopathy structural due to mutations in either alpha or beta globin structural substitution, addition or deletion of one or more aas in the globin chain i. Iron deficiency anemia, thalassemia, sickle cell anemiatrait. Beta thalassemia is a blood disorder that reduces the production of hemoglobin. See separate leaflet called sickle cell disease and sickle cell anaemia for more detail. Differential diagnosis of irondeficiency anemia from.
For example, if both parents have the faulty gene that causes beta thalassaemia major, theres a 1 in 4 chance of each child they have being born with the condition. Distinguishing iron deficiency anaemia from thalassemia. Distinguishing iron deficiency anaemia from thalassemia trait. People with thalassaemia produce either no or too little haemoglobin, which is used by red blood cells to carry oxygen around the body. Trait heterozygous hgb ad normalcytic, normalchromatic, no anemia per smear no cell changes, some targets hgb elec hgb d 95% disease hgb d 3550% hgb a 5065%trait no treatment normal lifespan. Beta thalassemia intermedia clinically and genotypically heterogeneous disorders, ranging in severity from mild to the severe transfusiondependent state.
The thalassemias are a diverse group of genetic blood diseases characterized by absent or decreased production of normal hemoglobin, resulting in a microcytic anemia of varying degree. It is a genetic trait passed down from parents to children. However, both alpha and beta thalassemia trait cause microcytic, hypochromic anaemia and are commonly misdiagnosed as ida. Rathod et al 1 calculated 6 previously described indexes on 200 patients and correlated the findings with the findings of hemoglobin electrophoresis. Hemoglobin is the ironcontaining protein in red blood cells that carries oxygen to cells throughout the body. Iron deficiency anemia and thalassemia syndromes, especially beta thalassemia trait btt, are the two most frequent microcytic hypochromic anemias highly prevalent in countries like india, 14. People who have alpha thalassemia trait can have mild anemia.
Thalassemias national heart, lung, and blood institute. The trans form of alpha thalassemia trait aa is common in africanamericans 2030 percent. The thalassemias have a distribution concomitant with areas where p. However, each child has a 50% or 1 in 2 chance to inherit beta thalassemia trait from the parent. Alpha thalassemia trait and beta thalassemia trait. The more severe beta types are beta thalassaemia major btm and. Normally, beta thalassemia trait does not cause any health problems. Thalassemias are inherited blood disorders, causing the body to make fewer healthy red blood cells and less hemoglobin than normal.
Thalassemias national heart, lung, and blood institute nhlbi. Occasionally up to 20 percent of the time, only a single mutation will be found that is indicative of thalassemia trait. Beta thalassaemia is the most common form of thalassaemia, and it is divided into thalassaemia trait sometimes called thalassaemia minor and thalassaemia major. This type of anaemia is different from iron deficiency anaemia and does not. In sickle cell, a mutation of the genes causes an abnormal hemoglobin to be produced, which causes the cells to form a crescent shape sickle.
Physicians often mistake alpha thalassemia trait for iron deficiency anemia and incorrectly prescribe iron supplements that have no effect on the anemia. Pdf role of hematological indices in the screening of. When there isnt enough hemoglobin, the bodys red blood cells dont function properly and they last shorter periods of time, so there are fewer healthy red blood cells. This condition behaves like sickle cell anaemia not like thalassaemia and is treated in the same way as sickle cell anaemia. Iron deficiency anemia ida and betathalassemia trait. Separating thalassemia trait and iron deficiency by simple. Normal alpha globin genes found on chromosome 16 people who do not produce enough alpha globin protein chains have alpha thalassemia. Nia, who has betathalassemia trait, and kiano, who has sickle cell trait, have been married for 10 years and have three children. In people with beta thalassemia, low levels of hemoglobin lead to a lack of oxygen in many parts of the body. Tt are the most common forms of microcytic ane mia. Trait heterozygous hgb ad normalcytic, normalchromatic, no anemia per smear no cell changes, some targets hgb elec hgb d 95% disease hgb d 3550% hgb a 5065% trait no treatment normal lifespan. Serum ferritin was measured to detect coexistence of iron deficiency anemia with thalassemia carrier. Beta thalassemia syndromes are a group of hereditary disorders characterized by a genetic deficiency in the synthesis of betaglobin chains.
Thalassaemia is caused by faulty genes that affect the production of haemoglobin. Beta thalassemia trait is inherited from ones parents, like hair or eye color. The nhs sickle cell and thalassaemia screening programme also has detailed leaflets about being a beta thalassaemia carrier pdf, 804kb or a delta beta thalassaemia carrier pdf, 779kb. Alpha thalassemia is a result of decreased production of alpha globins. Most persons with thalassemia trait are found incidentally when their complete blood count shows a 10mild microcytic anemia. Types thalassemia major cooleys anemia thalassemia minor severe form of beta thalassemia presence of one normal gene and one with a presence of two mutation. If you have mild thalassemia, you might not need treatment. The child born with thalassemia major has two genes for beta thalassemia and no normal betachain gene. The alpha thalassemias are concentrated in southeast asia.
Being a carrier of the trait is sometimes known as having the thalassaemia. Therefore, genetic analysis for both betathalassemia and alphathalassemia mutations are necessary. People with thalassemia have lower than usual rbcs in their bodies and consequently low levels of the protein haemoglobin. Laboratory diagnosis of hemoglobinopathies and thalassemia. Heterozygotes with defects in two of the four genes result in alpha thalassemia trait, and tend to develop mild to moderate microcytic anemia but with no symptoms.
Alpha thalassemia is a blood disorder that reduces the production of normal hemoglobin, the protein in red blood cells that carries oxygen to cells throughout the body there are four types of alpha thalassemia, hemoglobin bart hydrops fetalis syndrome or hb bart syndrome the more severe. Thalassemias are prevalent worldwide with 25,000 deaths in 20. Aug 01, 2009 alpha thalassemia typically results from deletions involving the hba1 and hba2 genes. A trait carrier of thalassemia will always be a trait carrier. Recently the journal has published interesting articles and correspondence on the subject of the separation of thalassemia trait tt from iron deficiency anemia ida by the use of rbc indices. Betathalassemia prevalence, pathophysiology and inheritance. Betathalassemia major severe, transfusiondependent anemia. A person with this condition simply carries the genetic trait for thalassemia with no health problems other than a possible mild anemia cooleys anemia foundation, 2010. Beta thalassemia specifically, it is characterized by a genetic deficiency in the synthesis of beta globin chains. It is a major diagnostic consideration to distinguish between the two.
Many times people with thalassemia are prescribed a supplemental b vitamin, known as folic acid, to help treat anemia. Beta thalassaemia is found in people from many countries around the world, but it is more common in people of mediterranean, middle eastern or asian origin. Thalassaemia is the name for a group of inherited conditions that affect a substance in the blood called haemoglobin. However, many people with this type of thalassemia have no signs or symptoms. Hemoglobin enables red blood cells to carry oxygen. Thalassemia trait is commonly detected when routine peripheral blood smear and complete blood count show microcytic anemia and elevated red cell count. Alpha thalassemia major with hemoglobin barts usually results in fatal hydrops fetalis.
Distinguishing iron deficiency anaemia from thalassemia trait in. For instance, if a person receives a beta thalassemia trait from his father and another from his mother, he will have beta thalassemia major. The clinical manifestations include hemolytic anemia and impaired iron handling, the severity of which depends on the degree of impairment in beta globin production. Beta thalassemia trait is also known as beta thalassemia minor. Alpha thalassemia intermedia, or hemoglobin h disease, causes hemolytic anemia. Beta thalassemia disease can only happen when both parents have beta thalassemia trait. But more severe forms might require regular blood transfusions. Jan 26, 2015 thalassaemia minor thalassaemia trait usually causes mild, asymptomatic microcytic anaemia, with no effect on mortality or significant morbidity. Thalassemia can cause anemia, leaving you fatigued. This causes a striking deficiency in beta chain production and in the production of hb a. If desired, the diagnosis of beta thalassemia trait can be confirmed with quantitative hemoglobin studies.
Thalassemia thaluhseemeuh is an inherited blood disorder that causes your body to have less hemoglobin than normal. Thalassemia is microcytic, hypochromic anemia caused by a geneticallybased decreased synthesis of 1 or several globin chains. The most common microcytic and hypochromic anemias are iron deficiency anemia and thalassemia trait. Or double heterozygous state such as sc, sicklethal, etc offers some protection against falciparum malaria sickle cell trait 8% of african americans are heterozygous for hgb s can increase the severity of thalassemia e, d homozygous state disease. The two most frequent types of microcytic anemia are beta thalassemia trait. This is called the trans form of alpha thalassemia trait. People who have alpha thalassemia trait have red blood cells rbcs that are smaller microcytic and paler hypochromic than normal, have a decreased mcv mean corpuscular volume, a measurement of the average size of a single rbc, and have a mild chronic anemia. The national family health survey nfhs3 of 2011 reveals the prevalence of anemia as 7080% in children, 70% in pregnant women, and 24% in adult men. A child can only be born with thalassaemia if they inherit these faulty genes from both parents. Or, if your partner has alpha plus thalassaemia trait, then your children might inherit hb h disease see below. In the homozygous state, beta thalassemia ie, thalassemia major causes severe, transfusiondependent anemia. If more than two genes are missing, moderate to severe anemia occurs. The type of thalassemia that a person has depends on how many and what type of traits for thalassemia a person has inherited, or received from their parents.
Over two million people in the united states carry the genetic trait for thalassemia. Akers as 2017 distinguishing iron deficiency anaemia from thalassemia trait in clinical obstetric practice pregnancy reprod, 2017 doi. Thalassaemia is an inherited condition affecting the blood. Beta thalassemia is an inherited hemoglobinopathy in which the production of one or both beta globin chains is impaired. One of the most common causes of microcytic hypochromic anemia is either iron deficiency or. We retrospectively evaluated the reliability of various indices for differential diagnosis of microcytosis and. Jan 22, 2018 thalassaemia is an inherited condition affecting the blood. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Betathalassemia minor trait clinically asymptomatic. Hematological indices for differential diagnosis of beta. Beta thalassemia major severe, transfusiondependent anemia. A person who has thalassemia trait may not have any symptoms at all or may have only mild anemia, while a person with thalassemia major may have severe symptoms and may need regular blood transfusions. Start studying iron deficiency anemia, thalassemia, sickle cell anemiatrait.
There are different types, which vary from a mild condition with no symptoms, to a serious or lifethreatening condition. This means you have one abnormal betahaemoglobin gene out of the normal two beta genes. People with thalassemia minor or trait usually do not need blood transfusions because they either do not have anemia or have only a mild anemia. The national family health survey nfhs3 of 2011 reveals the prevalence of anemia as 7080% in children, 70% in pregnant women, and 24% in. Learn more about causes, risk factors, screening and prevention, signs and symptoms, complications, diagnoses, treatments, and how to participate in clinical trials. When both parents have beta thalassemia trait, there is a 25% or 1 in 4 chance in each. Iron deficiency anemia and thalassemia minor are microcytic and. If one parent has beta thalassemia trait and the other parent has normal hemoglobin a, there is a 50 percent 1 in 2 chance with. Coexisting iron deficiency anemia and beta thalassemia. Thalassemia trait or minor should be considered when. Affected individuals also have a shortage of red blood cells anemia, which can. Thalassemia is a genetic blood disorder that impacts the ability of the blood to get oxygen to the bodys organs.
If you carry thalassaemia, you will not ever develop thalassaemia, but you may sometimes experience mild anaemia. The haematological variables, haematinic state, and placental function of more than 2000 pregnant women, heterozygous for either alpha or betathalassaemia genes, were examined during pregnancy. Thalassemia is an inherited blood disorder in which the body makes an abnormal form of hemoglobin. When the words trait, minor, intermedia, or major are used, these words describe how severe the thalassemia is. Treatments for thalassemias depend on the type and severity of the disorder. Alpha thalassemia trait occurs if one or two of the four genes are missing. Iron deficiency anaemia ida accounts for most cases 55% 70% depending on the population being studied. Beta thalassemia results from mutations in beta genes pathogenesis a result of the free alpha subunits two classes. The frequency of iron deficiency anemia and beta thalassemia. Apr 10, 2014 the two most frequent types of microcytic anemia are beta thalassemia trait. Alphathalassaemia is inherited as an autosomal recessive disorder characterised by a microcytic hypochromic anaemia, and a clinical phenotype varying from almost asymptomatic to a lethal. Anaemia in pregnancy is common, occurring in approximately 38% of pregnancies. Abstract thalassemias are genetic disorders inherited from a persons parents.
For the more severe forms of thalassaemia, modern treatment gives a good outlook, but lifelong monitoring and treatment are needed. Furthermore, other drawbacks of manual indices include the differences. The couple has one chance in four that any future child they have will have the two normal genes, sickle cell trait, hemoglobin c trait or hemoglobin sc disease a form of sickle cell disease. Coexisting iron deficiency anemia and beta thalassemia trait. In addition, parents and siblings should be screened. People with the first type of alpha thalassemia trait have one 1 alpha globin gene missing on each chromosome aa. Nov 22, 2019 thalassemia thaluhseemeuh is an inherited blood disorder that causes your body to have less hemoglobin than normal. Being a carrier of the trait is sometimes known as having the thalassaemia trait or having thalassaemia minor. Betathalassemia intermedia clinically and genotypically heterogeneous disorders, ranging in severity from mild to the severe transfusiondependent state. Beta thalassemia trait and beta thalassemia disease. Heterozygotes for a single gene defect results in silent alpha thalassemia state. Pdf a new index to discriminate between iron deficiency anemia.356 76 973 1558 1207 1371 1492 183 571 540 433 1016 547 1441 422 150 122 471 993 481 832 1378 1528 1311 854 929 1227 553 944 738 843 1244 1127