Thalassemia
Key points
- Thalassemias are hereditary disorders characterized by defective production of hemoglobin.
- Hemoglobin contains two chains, alpha and beta globin.
- With severe thalassemia, regular blood transfusions and folate supplementation are given.
- In severe thalassemia, death from heart failure can occur between the ages or 20 and 30.
Alternative names
Thalassemia; Mediterranean anemia; Cooley's anemia
Definition
Thalassemias are hereditary disorders characterized by defective production of hemoglobin. This leads to low production, and over destruction, of red blood cells.
Causes, incidence, and risk factors
Hemoglobin contains two chains, alpha and beta globin. Genetic defects can be inherited that cause imbalances in the production of either chain.
Beta thalassemias are caused by a mutation in the beta globin chain. Genes must be inherited from both parents to acquire the major form of the disease. If one gene is inherited, the person will be a carrier of the disease, but will not have symptoms. (This is the minor form.)
In the major form, children are normal at birth, but develop anemia during the first year of life. Growth failure, bone deformities, and enlarged liver and spleen are some of the problems that can occur. Blood transfusions may modify some of the disease manifestation, but iron overload from the transfusions can cause damage to the heart, liver, and endocrine systems.
The mild form of beta thalassemia produces small red blood cells, with no symptoms. Risk factors include a family history of thalassemia and an ethnic background susceptible to the disease.
Beta thalassemias occur in people of Mediterranean origin, and to a lesser extent, Chinese, other Asians, and blacks
Alpha thalassemias occur most commonly in people from southeast Asia and China, and are caused by deletion of a gene or genes from the globin chain. The most severe form of alpha thalassemia causes a stillborn fetus.
Symptoms
- Fatigue
- Shortness of breath
- Jaundice
- Bone deformities in the face
Signs and tests
- Enlarged spleen
- Peripheralblood smear shows small, abnormally-shaped red blood cells
- Complete blood count shows anemia
- Hemoglobin electrophoresis shows abnormal hemoglobin
This disease may also alter the results of the following tests:
- RBC indices (size, hemoglobin content)
- Osmotic fragility
Treatment
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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