Evaluation of Nutritional Status in Patients With Thalassemia Major in Assiut University Children Hospital

In Egypt beta thalassemia-major is the most common type with carrier rate of 5.3 to ≥9%and 1000 new cases born with beta-thalassemia major per 1.5 million live births per year.

Children born with thalassemia major are normal at birth, but develop severe hemolytic anemia during the first year of life. Symptoms are those of anemia (lethargy, poor feeding, pallor...etc.) failure to thrive and organomegaly. Later on they develop signs of extra medullary hematopoiesis .

Optimal nutritional status is important for growth, immune function, bone health and pubertal development . Various reports suggest the incidence of poor growth ranges from 25% to 75% depending on thalassemia syndrome and severity of disease. This marked growth deficits raise a red flag for any pediatrician to evaluate nutritional status of thalassemic patients and detect possible nutritional deficiencies and associated factors.

Etiology of delayed growth and malnutrition reported in thalassemic patient is multifactorial including :

1. Nutritional deprivation with or without feeding difficulties arising from fatigue and breathlessness
2. Increased energy expenditure secondary to hyper metabolism with or without heart failure
3. Gastrointestinal hypoxia which consequently produces anorexia and malabsorption
4. Reduction of biosynthetic activity of liver.
5. Disturbance of the endocrine function
6. Impaired synthetic hepatic function secondary to hemosiderosis and hepatitis.