Clinical manifestations of beta thalassemia major in the pediatric population: A systematic review

Authors

DOI:

https://doi.org/10.33448/rsd-v12i14.44596

Keywords:

Beta thalassemia major; Signs and symptoms; Pediatric.

Abstract

This study aimed to investigate information in the literature regarding the clinical manifestations associated with beta thalassemia major (BTM) in pediatric patients. To this end, a systematic review of the literature was carried out following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The descriptors “beta thalassemia”, “signs and symptoms” and “child” were used on the search platforms PubMed, Scielo, Science Direct, Science.gov and LILACS, to search for articles published between 2013 and 2023. After evaluating the databases data, 12 articles were selected to compose this work. All articles were published in English and the majority of them (n=7) had Egypt as their country of origin. Regarding the nature of the studies, it was observed that the majority of them were cross-sectional (n=7), followed by case-control studies (n=4) and only one of the cohort type. The articles described the identification of clinical manifestations in pediatric patients with BTM and the importance of their identification. It has been reported that dyslipidemias (changes in HDL-cholesterol, LDL-cholesterol and triglycerides) are related to cardiovascular changes in patients with BTM. Increased vascular endothelial growth factor was associated with the development of pulmonary hypertension. Excessive iron deposition has been associated with ventricular dysfunction, atherosclerosis, kidney and pancreatic disorders. Osteopenia associated with parathyroid hormonal changes have also been reported in BTM. Thus, it is concluded that BTM is the most common autosomal hereditary blood disease in the population and that its clinical manifestations have a negative impact on the health-related quality of life of pediatric patients.

References

Adly, A. A. M., Toaima, D. N., Mohamed, N. R., & El Seoud, K. M. A. (2014). Subclinical renal abnormalities in young thalassemia major and intermedia patients and its relation to chelation therapy. The Egyptian of Medical Human Genetics, 15: 369-377.

Bou-Fakhredin, R., Kuo, K. H. M., & Taher, A. L. T. (2023). Emerging therapies in β-thalassemia. Hematology/Oncology Clinics of North America, 37(2): 449-462.

Chapchap, E. C., Silva, M. M. A., Baroni, R. H., Araujo, A. S., Assis, R. A., Loggetto, S. R., Fabron Junior, A., Verissimo, M. P. A., Baldanzi, G.R., Fertrin, K. Y., Tricta, F., Piga, A. G., & Hamerschlak, N. (2023). Extramedullary haematopoiesis in patients with thalassemia: a cross-sectional description of its prevalence, clinical features and survival. Hematology, Transfusion, and Cell Therapy. ARTICLE IN PRESS.

Dan, M. O., Gutu, B. I., Severin, E., & Tanase, V. G. (2023). Innovative and needs-led research on β-thalassemia treatment methods. Frontiers in Hematology. 1-5.

Deraz, S. E., El Naby, S. A. A., & Mahmoud, A. A. (2021). Assessment of ventricular dysfunction in Egyptian children with beta-thalassemia major. Hematology/Oncology and Stem Cell Therapy. 14(3): 206-213.

El-Beshlawy, A., Dewedar, H., Hindawi, S., Alkindi, S., Tantawy, A. A., Yassin, M. A., & Taher, A. T. (2023). Management of transfusion-dependent β-thalassemia (TDT): expert insights and practical overview from the Middle East. Blood Reviews, ARTICLE IN PRESS.

El-Nashar, M., Mortagy, A. K., El-Beblawy, N. M. S., El-Gohary, E., Kamel, I. M., Rashad, M., & Mouharam, W. A. (2017). Parathyroid hormone in pediatric patients with β-thalassemia major and its relation to bone mineral density; a case control study. The Egyptian Journal of Medical Human Genetics. 18: 75-78.

Fonri, G. L., Grazzini, G., Boudreaux, J., Agostini, V., & Omert, L. (2023a). Global burden and unmet needs in the treatment of trnasfusion-dependent β-thalassemia. Frontiers in Hematology, 2: 1-12.

Forni, G. L., Gianesin, B., Musallan, K. M., Longo, F., Rosso, R., Lisi, R., Gamberini, M. R., Pinto, V. M. Graziadei, G., Vitucci, A., Bonetti, F., Musto, P., Piga, A., Cappellini, M. D., & Borgna-Pignatti, C. (2023b). Overall and complication-free survival in a large cohort of patients with β-thalassemia major followed over 50 years. American Journal of Hematology, 98(3): 381-387.

Ibrahim, A. S., El-Fatah, A. H. A., El-Halim, A. F. A., & Mohamed, F. F. (2023). Serum ferritin levels and Other associated parameters with diabetes mellitus in adult patients suffering from beta thalassemia major. Journal of Blood Medicine, 14: 67-81.

Ibrahim, M. H., Azab, A. A., Kamal, N. M., Salama, M. A., Ebrahim, S. A., Shahin, A. M., El-Sadek, A. E., Abdulghany, W. E., Sherief, L. M., & Abdallan, E. A. A. (2016). Early detection of myocardial dysfunction in poorly treated pediatric thalassemia children and adolescentes: two Saudi centers experience. Annals of Medicine and Surgery, 9: 6-11.

Ismail, D. K., El-Tagui, M. H., Hussein, Z. A., Eid, M. A., & Aly, S. M. (2018). Evaluation of health-related quality of life and muscular strength in children with beta thalassemia major. The Egyptian Journal of Medical Human Genetics. 19: 353-357.

Jabbar, H. K., Hassan, M. K., & Al-Naama, L. M. (2023). Lipids profile in children and adolescentes with β-thalassemia major. Hematology, Transfusion and Cell Therapy. 45(4): 467-472.

Landis, J. R., & Koch, G. G. (1977) The measurement of observer agreement for categorical data. Biometrics, 33(1): 159-174.

Macharia, A. W., Mochamah, G., Oyoga, S., Ndila, C. M., Nyutu, G., Tendwa, M., Nyatichi, E., Makale, J., Ware, R. E., & Williams, T. N. (2020). β-thalassemia pathogenic variants in a cohort of children from the East African coast. Molecular Genetics and Medicine, 8:1-9.

Musallam, K. M., Lombard, L., Kistler, K. D., Arregui, M., Gilroy, K. S., Chanberlain, C., Zagadaialov, E., Ruiz, K., & Taher, A. L. (2023). Epidemiology of clinically significance forms of alpha- and beta-thalassemia: A global map of evidence and gaps. American Journal Of Hematology, 98: 1436-1451.

Prisma (2020). Transparent reporting of systematic reviews and meta-analysses. http://www.prisma-statement.org)

Rao, E., Chandraker, S. K., Singh, M. M., & Kumar, R. (2023). Global distribution of beta-thalassemia mutations: na update. Gene, ARTICLE IN PRESS.

Sherief, L. M., Dawood, O., Ali, A., Sherbiny, H. S., Kamal, N. M., Elshanshory, M., Alazez, O. A., Alhady, M. A., Nour, M., & Mokhtar, W. A. (2017). Premature atherosclerosis in children with beta-thalassemia major: mew diagnostic marker. BMC Pediatrics, 17(69): 1-8.

Soteriades, S., Angastiniotis, M., Farmakis, D., Eleftheriou, A., & Maggio, A. (2023). The need for translational epidemiology in beta thalassemia syndromes. Hematology/Oncology Clinics of North America, 37: 261-272.

Tabatabaie, M., Hooman, N., Arjmandi-Rafsanjani, K., & Isa-Tafreshi, R. (2013). Ambulatory blood pressure monitoring for children with β-thalassemia major. Iranian Journal of Kidney Diseases, 7(4): 299-303.

Zha, G., Xiao, X., Tian, Y., Zhu, H., Chen, P., Zhang, Q., Yu, C., Li, H., Wang, Y., & Cao, C. (2023). An efficient isoeletric focusing of microcolumn array chip for screening of adult beta-thalassemia. Clinica Chimica Acta, 538: 124-130.

Published

23/12/2023

How to Cite

SILVA, N. R. .; QUEIROZ, R. C. .; MENEZES NETO, A. G. de .; COSTA, J. M. B. .; RODRIGUES, I. J. F. . Clinical manifestations of beta thalassemia major in the pediatric population: A systematic review. Research, Society and Development, [S. l.], v. 12, n. 14, p. e95121444596, 2023. DOI: 10.33448/rsd-v12i14.44596. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/44596. Acesso em: 25 dec. 2024.

Issue

Section

Health Sciences