Managing a Thalassemia Patient
As we know, there is no cure for Thalassemia, other than taking the risk of a Bone Marrow Transplant. A Thalassemia patient may need to spend their entire life with this disorder. In order to be able to lead a healthy life, there are some set of precautions that one can take to manage their lives with Thalassemia. Here, we are listing down a few tests that need to be performed to keep a regular check on the patient’s health.
Test to be done every 3 months:-
Serum Ferritin Test: – This measures the amount of iron stored in one’s body, which can give an overall picture of the iron levels. The patients suffering from thalassemia have excess iron content in their body due to regular blood transfusions and also their body does not have enough iron absorbability power, so they need to get this test done once every 3 months to check and maintain the iron level in their body. In general, doctor may advice a thalassemia patient to initiate iron extraction once the level goes beyond 1000ng/ml. Excess iron level in the body can be removed by a process called chelation, which is a clinical part of treatment. There are a lot of oral drugs available in the market, now-a-days, which help in iron chelation.
Blood Sugar Test: – A blood sugar test is a procedure that measures the amount of sugar, or glucose, in the blood. Some people with thalassemia develop diabetes, which adds another burden to maintain their health. It is very important for them to prevent diabetes and keep a check on the sugar level.
Thyroid Level Test: A thyroid level test is a series of blood test which is performed to understand the working of thyroid gland. In thalassemia patients, iron overload in the body affects the thyroid gland and can hinder the gland to do its job. The thyroid gland secretes hormones which assist in growth and development of the body. When the glands malfunction due to iron overload in the body, it causes decrease in the levels of calcium and phosphorus in the body. So a thalassemia patient must ensure that he is keeping a regular check of these levels in their body. If proper transfusions and chelation therapy is done, one may be able to avoid thyroid problems.
Tests to be done every 6 months: –
Renal Function Test: – It is a kidney function test that is performed to check the functioning of kidney. Levels of sodium, potassium, calcium, uric acid, protein, etc. are tested. The deposit of iron on the body parts leads to organ failure and can ultimately lead to death, so by conducting these tests a person can keep a regular check of his/her kidney’s health.
Liver Function Test: – About one third of iron content stored in our body is present in the liver. In case of thalassemia patients, this one-third level increases as they don’t have a proper iron absorbability power. Liver Function Test is a simple blood test, which helps the patient to know about their liver’s health.
Transfusion Transmitted Infection: – A Transfusion transmitted infection (TTI) is a virus, or a parasite which is transmitted to the recipient while he takes blood from the donor. Viruses such as HIV, Hepatitis A/B/C cause these infections. Transfusion of infected blood may lead to such infections. So, the donor’s blood must be properly checked before transfusion and a multi-step process called ‘pathogen activation’ can be performed to remove most viruses and bacteria from the blood.
Tests to be done every one year: –
MRI Scan: – Magnetic resonance imaging (MRI) is an imaging technique which is used to get images of internal body parts. For thalassemia patients, T2 MRI is used to measure the iron level present on the body organs like liver, heart, pancreas etc. T2 MRI is a type of MRI in which both the fat and water in the body are visible in the images. Iron darkens the images taken by MRI, so we use the darkening rate of the images to measure the iron accumulation in human body organs by the use of computer programs. Iron can accumulate in human body organs silently for many years and also different organs have different iron load/unload rate. So, once a year, MRI checkup should be performed to monitor the level of iron in the various body parts.
Dexa Scan: – A DEXA scan is a special type of X-ray that measures bone mineral density (BMD). DEXA scans are used to diagnose osteoporosis, a condition that is characterized by a decrease in the density of the bones which reduces its strength and makes the bones fragile. In case of thalassemia patients, a similar situation occurs because of two main reasons i.e. lack of calcium and irregular transfusions of blood. Thalassemia can make the patient’s bone marrow expand which will lead to thin bones and it increases the chance of broken bones. If regular blood transfusion is not done, the bones try to produce blood and hence they deform. Some patients may have issues such as facial deformation, deformity in other bones etc. which last lifetime. So Dexa scan must be performed once in a year at least.