Key result
A restrictive pulmonary pattern was present in 38.46% of young patients with β-thalassaemia major, with age and serum ferritin levels identified as major predictors.
Cross-Sectional (n=52)
A significant proportion of young patients with β-thalassemia major exhibit restrictive pulmonary dysfunction, which is strongly predicted by increasing age and serum ferritin levels.
Supports PFT monitoring in young β-thalassemia patients; hypothesis-generating for ferritin as modifiable risk factor.
BACKGROUND: Pulmonary dysfunction represents one of the most undervalued and less recognized complications in patients with β-thalassaemia. OBJECTIVES: The aim of this study was to assess the pattern of pulmonary dysfunction and consequently to investigate possible associated factors that might contribute to lung impairment in young patients with β-thalassaemia major. METHODS: Fifty-two children and young adults (mean age: 21.33 ± 6.24 years) with β-thalassaemia major on conventional treatment (transfusions and iron chelation therapy) were included in the study. A complete computerized pulmonary function testing (PFT) system for recording pulmonary diffusion capacity and simultaneous determination of alveolar volume and pulmonary volumes was equipped. RESULTS: Results showed that 20 patients (38.46%) had restrictive pulmonary pattern that was preferentially observed in older and shorter patients. Serum ferritin levels were higher in the restrictive group (2,096 ± 1,831 ng/dl) compared to patients with normal pulmonary function (1,354 ± 942 ng/dl) (P = 0.066). Diffusional impairment characterized by significantly lower DLCO*% values, was observed in the restrictive group (P = 0.004), implicating the 62.5% of the population studied. Paired linear correlations showed that age was negatively correlated to DLCO*% (r = -0.548, P < 0.001) and SaO(2) % (r = -0.789, P < 0.001) and with most of the pulmonary functional parameters that determine a restrictive. Multivariate regression analysis identified age as the major predictor for restrictive pulmonopathy followed by serum ferritin levels. CONCLUSIONS: Our study shows that pulmonary impairment is shown in a great proportion even among asymptomatic young thalassaemic patients, thus, regular screening of pulmonary function should be adopted in the routine clinical follow up of these patients.
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Bourli et al. (2012) conducted a cross-sectional in β-thalassaemia major (n=52). Age and serum ferritin levels was evaluated on Restrictive pulmonary pattern. A restrictive pulmonary pattern was present in 38.46% of young patients with β-thalassaemia major, with age and serum ferritin levels identified as major predictors.
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