Effect of Blood Transfusions on Oxidant/Antioxidants Balance in Beta Thalassaemia Major Patients BC14-BC18
Dr. Prashant Jagannathrao Hisalkar,
Professor and Head, Department of Biochemistry, Government Medical College, Dungarpur-314001, Rajasthan, India.
Introduction: Thalassaemia is the major health problem all over India which is prevalent amongst all population groups irrespective of caste, religion and creed. Number of studies from different parts of the country provides the data on distribution of various haemoglobinopathies but there are limited data from Northern Maharashtra, India. Regular blood transfusion is one of the conventional treatments for survival in patients with Beta Thalassaemia Major (BTM). This may cause oxidative stress and tissue injury due to iron overload and altered antioxidant enzymes.
Aim: To assess the effect of number of blood transfusions on oxidant/antioxidant balance in patients with beta thalassaemia major of North Maharashtra region.
Materials and Methods: Patients were divided into two groups on the basis of number of blood transfusions. Group A having number of transfusion =140 and Group B having number of transfusion >140. These groups were compared on the basis of haematological and biochemical parameters.
Results: Iron overload in Group B than Group A was indicated by significantly (p<0.0001) high levels of iron, ferritin and Transferrin Saturation (TS) with significantly low level of Total Iron Binding Capacity (TIBC). Oxidative stress in Group B is higher indicated by significantly (p<0.0001) high level of Malondialdehyde (MDA) and Copper (Cu) with significantly low levels of Glutathione Peroxidase (GPx), Zinc (Zn) and vitamin C than Group A. We also observed non significant difference in Superoxide Dismutase (SOD) and serum Ceruloplasmin (CP) in both groups.
Conclusion: The above data implies that after each blood transfusions, accumulation of free iron in the body of thalassaemic patients increases. This excess iron deposited in body tissues leads to many pathophysiological conditions like expanded plasma volume, cardiac output, reduced glucose tolerance, hepatitis, various endocrine abnormalities, cardiac and renal dysfunctions. Estimation of these biochemical parameters along with blood transfusion would help in early detection of the associated complications in these patients. This would be quite helpful to reduce the burden of this disease through preventive measures.