Coagulation Abnormalities in Pediatric Patients with β-Thalassemia, An experience at a Tertiary Care Hospital: Coagulation Abnormalities in Pediatric Patients

Ayesha Shabbir; Saima  Farhan; Attiq  Ur Rehman; Neelam Mazhar; Sidra Hareem; Iram Iqbal

doi:10.54393/pbmj.v6i09.915

Authors

Ayesha Shabbir Department of Hematology & Transfusion Medicine, University of Child Health Sciences, The Children's Hospital. Lahore, Pakistan
Saima Farhan Department of Hematology & Transfusion Medicine, University of Child Health Sciences, The Children's Hospital. Lahore, Pakistan
Attiq Ur Rehman The School of Allied Health Sciences, University of Child Health Sciences, The Children's Hospital. Lahore, Pakistan
Neelam Mazhar Department of Hematology & Transfusion Medicine, University of Child Health Sciences, The Children's Hospital. Lahore, Pakistan
Sidra Hareem Department of Hematology & Transfusion Medicine, University of Child Health Sciences, The Children's Hospital. Lahore, Pakistan
Iram Iqbal Department of Hematology & Transfusion Medicine, Lahore General Hospital, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v6i09.915

Keywords:

Coagulation, Thalassemia, Thromboembolic Events, Liver Enzymes, Coagulation Inhibitors

Abstract

Life expectancy in thalassemia has markedly improved due to consistent blood transfer and amenability with iron chelation therapy, therefore this improvement is conditioned with various thromboembolic problems of this prolonged disorder including thromboembolic complaints. Objective: To determine coagulation abnormalities in beta (β) thalassemia major patients who have been multi transfused. Methods: This observational study was conducted at Department of Haematology & Transfusion Medicine, Children hospital & University of Child Health Sciences (CH&UCHS), Lahore, from October 2022 to January 2023. The study included 60 β-thalassemic patient, age less than 16 years whose samples were compared with upper and lower normal value as regards to Prothrombin Time (PT), Active Partial Thromboplastin Time (APTT), Protein S, Protein C, liver enzymes (Alanine Transaminase (ALT), Aspartate Transaminase (AST), Gamma-Glutamyl Transferase (GGT). The data were analyzed using IBM SPSS version 23.0. Results: When values were compared, natural clotting inhibitors (Protein S, Protein C) were remarkably reduced in β-thalassemic paeds patients (p<0.001).PT and APTT were prolonged in thalassemic children (p>0.05 and p<0.05 correspondingly). There was substantial increase in concentrations of ALT and AST in β-thalassemic patients (p < 0.001 and p < 0.001 respectively) due to iron over load by multiple transfusions. Conclusions: Marked changes in coagulation inhibition supporting thrombotic tendency was observed in thalassemic children. There were reduced levels of protein C and protein S, independent of slightly prolonged PT and APTT and elevated levels of ALT, AST with normal GGT in thalassemic children.

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