Alternating anterior and posterior fascicular block and left septal fascicular block
Section of Cardiology, Ospedale Privato Quisisana, Ferrara, Italy
Medical director: Doc. Cinchini Elisabetta
De Sanctis V. - Soliman A. - Yassin M.
Abstract
Thalassaemia is one of the most common genetic disorders caused by a reduction of the globin chains leading to chronic haemolytic anaemia from birth. The mainstay of treatment is blood transfusion to maintain adequate levels of the haemoglobin. Iron overload in B-thalassaemia major patients is secondary to multiple blood transfusions and increased iron absorption.
Excess iron potentially catalyzes free-radicals generation and impairment in cellular function and integrity. Extensive iron-induced injury develops in the heart, liver, pancreas and endocrine system. Pancreatic iron loading in thalassaemia major patients begins at early childhood, and the prevalence of diabetes mellitus (DM) ranges from 6.4% to 14.1% in cross-sectional studies.
Both insulin resistance and decreased insulin secretion contribute to DM in thalassaemia major patients. This has been shown by oral glucose tolerance test, euglycemic insulin clamp, homeostatic model assessment, intravenous glucose tolerance test and continuous glucose monitoring system.
The prevalence of DM in thalassaemia has been shown to correlate with serum ferritin concentration, hepatitis C infection, and pancreatic and cardiac iron measured by imaging techniques. Therefore the incidence of disturbed glucose homeostasis depends on adherence to chelation treatment, the adequacy of the dosage, the chemical properties of the chelating agent and the prevention of liver infections.
PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/23687960
Section of Cardiology, Ospedale Privato Quisisana, Ferrara, Italy
Section of Cardiology, Ospedale Privato Quisisana, Ferrara, Italy
Michele Brignole, MD, Antonella Groppelli, MD, Vincenzo Russo, MD, Artur Fedorowski, MD, Gert van Dijk, MD, Paolo Alboni, MD
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Impaired glucose tolerance, diabetes mellitus, Hypothyroidism and Hypoparatiroidism
Short stature, Delayed puberty and Hypogonadism
The aims and the actors of Equality Project: The management of thalassemia
Typical vasovagal syncope as a defense mechanism for the heart by contrasting sympathetic overactivity
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