Severe infections in thalassaemic patients: prevalence and predisposing factors
Open accessAbstract
The incidence of infections among patients with thalassaemia and the role of risk factors for infection are uncertain. We studied the occurrence of infections necessitating hospitalisation in 92 homozygous beta-thalassaemia patients who had been followed longitudinally for decades, and investigated the role of potential risk factors for these infections. Pneumonia accounted for 26% of the infections and fever of unknown origin for 14%. Staphylococcus aureus was the major pathogen possibly related to injections associated with intensive chelation with deferoxamine. There was a significant increase in the rate of infection over time, notably after 15 years. Splenectomy correlated with the incidence of infection (P < 0.001) without being confounded by other variables and with highest frequencies of infections present after 10 years. A direct correlation between iron overload and infection was evident only before the initiation of iron-chelating treatment (P < 0.01). Following initiation of deferoxamine, paradoxically, the infection rate increased (P = 0.046). The combination of splenectomy and deferoxamine treatment was associated with the highest adjusted infection rate. Parathyroid dysfunction and glucose-6-phosphate dehydrogenase deficiency were significantly associated with infection (P = 0.02 and P = 0.04 respectively). The infection rate in thalassaemia is affected mainly by the duration of the disease and is increased by splenectomy and, in the long term, by treatment with deferoxamine.
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Infections are a major cause of death in thalassaemia patients, accounting for 12-46% of mortality.
“Infections are among the major causes of mortality in patients with thalassaemia (12–46%) along with cardiovascular disease and liver failure [18].”
From A battle for iron: host sequestration and Staphylococcus aureus acquisition (2012) · cites this paper as [18]
Iron overload in thalassaemia has been implicated as a cause of the increased infections in this population.
“Iron overload associated with thalassaemia patients has been implicated as a cause for the increased infections within this population [18].”
From A battle for iron: host sequestration and Staphylococcus aureus acquisition (2012) · cites this paper as [18]
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- Authors
- Rahav, G., Volach, V., Shapiro, M., Rund, D., Rachmilewitz, E. A., & Goldfarb, A.
- Affiliations
- Hebrew University of Jerusalem (IL)
- Corresponding author
- Rahav, Galia
- Venue
- British Journal of Haematology
- Publisher
- Wiley
- Published
- 2006-05-16
- Volume
- 133
- Issue
- 6
- Pages
- 667-674
- ISSN
- 0007-1048 (ISSN-L)
- 1365-2141
- OpenAlex
- W2000849599
- Cited by
- 79
- References
- 36
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 2 · 2020: 8 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 4 · 2015: 3 · 2014: 5 · 2013: 4 · 2012: 1
- FWCI
- 1.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Haematology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Keywords
- beta-thalassemia, serious infections, hospitalization, pneumonia, fever of unknown origin, Staphylococcus aureus, deferoxamine, iron chelation, splenectomy, iron overload, parathyroid dysfunction, glucose-6-phosphate dehydrogenase deficiency, infection risk factors, disease duration
- MeSH terms
- Adolescent, Adult, Bacterial Infections, Child, Deferoxamine, Female, Ferritins, Hospitalization, Humans, Longitudinal Studies, Male, Opportunistic Infections, Postoperative Period, Risk Factors, Splenectomy, beta-Thalassemia, Siderophores, Iron Overload
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