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By Dr. Androulla Efeftheriou

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Hypersplenism Many patients with thalassaemia major experience problems of the spleen - a soft, purplish organ about the size of a fist, located on the left-hand side just below the diaphragm, under the ribs (see 5a). A normal spleen contains 20-30ml of red blood cells. However, in patients with persistent moderate to severe anaemia as a result of inappropriate blood transfusion, the spleen may hold a litre (1000ml) or more of blood. e. the synthesis of red blood cells outside the normal site of production, the bone marrow - in an effort to help the body overcome anaemia.

Other factors such as iron load may affect growth in thalassaemia. However, it Infection with Yersinia enterocolitica - infections caused by the bacterium Yersinia enterocolitica are also commonly associated with the use of DFO. All living organisms need iron to grow, including bacteria, parasites and other pathogens. Most have special structures that enable them to acquire iron. e. the compound formed after iron binds with DFO. DFO is a natural carrier of iron something known as a siderophore (from the Greek sidero, meaning iron, and phoro, meaning carry) - and it therefore in effect supports the growth of Yersinia by providing it with iron.

However, it is much better to use chelation therapy to prevent heart disease occurring at all rather than starting once cardiac complications have already taken hold. Assessing iron concentration in heart tissue has been difficult. However, recent developments in the use of MRI indicate the technique may be an extremely promising means of making direct measurements of heart iron content. In short, the treatment of cardiac complications in thalassaemia major depends on intensified treatments to remove accumulated tissue iron, in addition to conventional drugs used to support failing cardiac muscle, such as: a) drugs that improve the pumping action of the heart.

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