What is thalassemia?

Written by He Li Fang
Hematology
Updated on September 26, 2024
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Thalassemia, commonly referred to as thalassemia, is a type of hereditary hemolytic anemia caused by mutations or deletions in the globin gene, leading to insufficient synthesis of globin peptide chains. This condition is termed thalassemia when characterized by a deficiency in globin chains. Clinically, based on the severity of the anemia, it is categorized into mild, intermediate, and severe types. The disease is widely distributed in many regions of the world, predominantly prevalent in the Mediterranean area, the Middle East, Africa, Southeast Asia, and southern China, including Guangxi, Guangdong, Sichuan, Hong Kong, northern Taiwan, as well as Yunnan, Guizhou, Hainan, Fujian, Hunan, and Hubei, with less prevalence in the north of China.

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Written by He Li Fang
Hematology
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How long can someone with thalassemia live?

The lifespan of patients with thalassemia depends on its specific type. Thalassemia is categorized into four types: silent carrier, thalassemia trait, hemoglobin H disease, and hemoglobin Bart's hydrops fetalis syndrome. Among these, silent carriers and those with thalassemia trait present no clinical symptoms or characteristics. Patients with hemoglobin H disease appear normal at birth and show no symptoms of anemia before the age of one. As they age, the characteristics of hemoglobin H disease gradually emerge, manifesting as mild to severe chronic anemia. However, these patients do not exhibit the physical appearance typical of hemoglobin anemia, their physiological development is normal, and they can live long term without significant impact on lifespan. Patients with hemoglobin Bart's hydrops fetalis syndrome can cause stillbirth, miscarriage, or premature birth during the late pregnancy stages of 30 to 40 weeks, and most die within hours, significantly affecting lifespan. Thalassemia is also divided into mild, intermediate, and severe forms. Most patients with mild thalassemia have no symptoms, though a few may show signs of mild anemia and have normal growth and development without skeletal abnormalities. Severe thalassemia patients, however, are indistinguishable from normal infants at birth but start to show clinical symptoms between three to six months old, and the anemia progressively worsens. They require regular blood transfusions for survival. These patients often evolve to develop the typical appearance associated with thalassemia. Due to long-term transfusions, they suffer from iron overload, compromised immune systems, recurrent infections, and myocardial damage. Consequently, many children with severe thalassemia die young, and those who live into their teens often exhibit delayed sexual maturity and underdeveloped secondary sexual characteristics.

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Written by Li Fang Fang
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Dietary Considerations for Thalassemia

Thalassemia, also known as hemoglobin synthesis disorder anemia, is a genetic disease that falls under the category of genetic disorders. It is caused by abnormalities in the genes related to globin, leading to a deficiency in globin quantity, which in turn causes thalassemia. Since thalassemia is a genetic disorder, there are no specific dietary considerations. The severity of thalassemia is also defined by the number of affected genes; the fewer the affected genes, the milder the condition.

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Written by Li Fang Fang
Hematology
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What to eat for anemia in thalassemia

Thalassemia belongs to genetic diseases, hereditary diseases. The cause of the disease is due to genetic and chromosomal abnormalities that lead to congenital defects in the quantity or quality of globin production, resulting in thalassemia. Therefore, no matter what thalassemia patients eat, it cannot help in blood replenishment. For thalassemia patients with severe anemia symptoms, the primary treatment method is red blood cell transfusion support therapy, and oral medications are ineffective. It is important to note that thalassemia patients who undergo repeated red blood cell transfusions need chelation therapy.

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Written by Zhang Xiao Le
Hematology
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Is the level of ferritin high or low in thalassemia?

In thalassemia, ferritin levels are generally normal. Clinically, both thalassemia and iron deficiency anemia present as microcytic hypochromic anemia. The simplest differentiation between the two is by checking ferritin levels. In iron deficiency anemia, ferritin levels are usually significantly decreased, whereas in thalassemia, ferritin levels tend to be normal. If microcytic hypochromic anemia is detected with normal ferritin levels, further tests such as hemoglobin electrophoresis and screening for thalassemia genes are needed to confirm if it is thalassemia, the specific type, and the severity, to guide subsequent treatment methods.

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Written by Zhang Xiao Le
Hematology
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What should I eat if I occasionally feel dizzy due to thalassemia?

Patients with thalassemia who experience dizziness typically indicate worsening anemia, and can take folic acid tablets orally. Folic acid is an important raw material for the production of red blood cells, and supplementing with folic acid aids in the recovery from anemia. Thalassemia is a hereditary hemolytic anemia, and there is currently no specific drug for its treatment; it is primarily managed symptomatically. If the anemia is severe, red blood cell transfusions may also be used to correct the anemia. Additionally, severe thalasemia may consider allogeneic hematopoietic stem cell transplantation. Apart from anemia, further investigations should be conducted to rule out cervical spondylosis, cerebrovascular diseases, and otolithiasis when dealing with dizziness in thalassemia patients.