Beta Thalassemia Major with Diabetes Mellitus: A Case Report

Authors

  • Dr. Sneha Mhaske DVVPFs Medical College & Hospital, Ahmednagar-414111, Maharashtra, India
  • Dr. Abhijit Shinde
  • Dr. Sonal Shinde
  • Dr. Ramesh Kothari
  • Dr. Ganesh Misal
  • Dr. Sushruta Kumar
  • Prof. Dr. Sunil Natha Mhaske

DOI:

https://doi.org/10.46858/vimshsj.8208

Keywords:

Thalassemia, Diabetes Mellitus, Iron chelation, Blood transfusion, Hyperglycemia

Abstract

Thalassemia results from defects in normal hemoglobin production, and represents the most common inherited anemia worldwide. Diabetes is a complication of b-thalassemia major. We report a case of Diabetes mellitus in a known case of beta thalassemia major. Patient had undergone Splenectomy 1 year back. Patient is taking chelating agent Defasirox 1000mg orally once a day in the morning. Family history reveals, born through third degree consanguineous marri age. The patient was then subjected for laboratory examination reveals BSL was high, urine ketone 2+,urine sugar 3+, ABG was normal, HbA1c was 13 & 3 month old report of  serum ferritin 1200 ng/dl. Multidisciplinary management was instituted. Blood sugar level got controlled over subcutaneous insulin. Patient may have landed in Diabetic ketoacidosis but was promptly diagnosed & treated. This case is presented for its rarity. As the life expectancy of patients with thalassaemia increases, this will also expose our patients potentially to many more years of hyperglycaemia and diabetes. Sustaining metabolic control and controlling cardiovascular risk factors will be critical in the future for preventing complications due to diabetes.

Downloads

Download data is not yet available.

References

Miri Moghaddam E, Zadeh Vakili A, Rouhani Z, Naderi M, Eshghi P, Khazaei Feizabad A. Molecular basis and prenatal diagnosis of ?-thalassaemia among Balouch population in Iran. Prenatal Diagnosis. 2011;31(8):788-91.

Miri-Moghaddam E, Naderi M, Izadi S, Mashhadi M. Causes of new cases of major thalassaemia in sistan and balouchistan province in South-East of Iran. Iranian Journal of Public Health. 2012;41(11):67.

Magro S, Puzzonia P, Consarino C, et al. Hypothyroidism in patients with thalassaemia syndromes. Acta Haematologica. 1990; 84:72-6.

De Sanctis V. Growth and puberty and its management in thalassaemia. Hormone Research 2002; 58: 72-9.

Delvecchio M, Cavallo L. Growth and endocrine function in thalassemia major in childhood and adolescence. Journal of Endocrinological Investigation 2010; 33(1): 61-8.

Borgna-Pignatti C, Rugolotto S, De Stefano P, Zhao H, Cappellini MD, Del Vecchio GC, Romeo MA, Forni GL, Gamberini MR, Ghilardi R, Piga A, Cnaan A. Survival and complications in patients with thalassemia major treated with transfusion and deferoxamine. Haematologica 2004;89(10):1187-93.

Cunningham MJ, Macklin EA, Neufeld EJ, Cohen AR. Thalassemia Clinical Research Network. Complications of beta-thalassemia major in North America. Blood 2004;104(1):34-9.

Gamberini MR, Fortini M, De Sanctis V, Gilli G, Testa MR. Diabetes mellitus and impaired glucose tolerance in thalassaemia major: incidence, prevalence, risk factors and survival in patients followed in the Ferrara Center. Pediatr Endocrinol Rev. 2004;2 Suppl 2:285-91.

Angelopoulos NG, Zervas A, Livadas S, Adamopoulos I, Giannopoulos D, Goula A, Tolis G. Reduced insulin secretion in normoglycaemic patients with beta-thalassaemia major. Diabet Med. 2006;23(12):1327-31.

Monge L, Pinach S, Caramellino L, Bertero MT, Dall’omo A, Carta Q. The possible role of autoimmunity in the pathogenesis of diabetes in B-thalassemia major. Diabetes MeTable 2001;27(2 Pt 1):149-54.

Mowla A, Karimi M, Afrasiabi A, De Sanctis V. Prevalence of diabetes mellitus and impaired glucose tolerance in beta-thalassemia patients with and without hepatitis C virus infection. Pediatr Endocrinol Rev. 2004;2 Suppl 2:282-4.

Thalassaemia International Federation. Guidelines for the Clinical Management of Thalassaemia. 2nd Revised Edition 2008. Available at: http://www.thalassaemia.org.cy/publications.html.

United Kingdom Thalassaemia Society. Standards for the Clinical Care of Children and Adults with Thalassaemia in the UK. 2nd Edition 2008. Available at: http://www.ukts.org/pdf.html.

Berdoukas V, Farmaki K, Wood JC, Coates T. Iron chelation in thalassemia: time to reconsider our comfort zones. Expert Rev Hematol. 2011;4(1):17-26.

Maria Barnard, Ploutarchos Tzoulis. Diabetes and thalassaemia. Thalassaemia reports 2013; 3(s1):49.

Adam Algren D. Review of oral iron chelators for the treatment of iron overload in paediatric patients (www.who.int>expert>applications>iron).

Cappellini MD, Cohen A, Porter J, Taher A, Viprakasit V. Guidelines for the management of transfusion dependent thalassaemia. Thalassaemia international federation. 2014; publication no. 20: 3rd edition.

Downloads

Published

2021-06-17

How to Cite

Mhaske, D. S., Shinde, D. A., Dr. Sonal Shinde, Dr. Ramesh Kothari, Dr. Ganesh Misal, Dr. Sushruta Kumar, & Mhaske, P. D. S. N. . (2021). Beta Thalassemia Major with Diabetes Mellitus: A Case Report. VIMS Health Science Journal, 8(2), 85–88. https://doi.org/10.46858/vimshsj.8208

Issue

Section

Case Report

Most read articles by the same author(s)

1 2 3 4 > >>