Pulmonary function tests in children with beta-thalassemia major

Abstract

The objective of the study was to study the pattern of lung functions in thalassemia major children and correlation of pulmonary function tests (PFTs) with serum ferritin. A hospital-based cross-sectional descriptive study done from January 2017 to December 2017. Inclusion criteria: Children with confirmed diagnosis of beta-thalassemia major in the age group of 5–15 years were included in the study. Exclusion criteria: Already diagnosed cases of pulmonary dysfunctions, CHD and RHD were excluded from the study. All enrolled children underwent a detailed clinical history, physical examination and blood sample were sent for Hb and serum ferritin before blood transfusion (BT). PFT was done within 24 h of BT using spirometer (Helios-401). Statistical analysis was done using SPSS (Version22). Forty-five children enrolled in the study and majority of them were <10 years (37 children) with M:F ratio 1.6:1. The pulmonary dysfunction was present in 35 (77.8%), but none of them had respiratory symptoms. The pulmonary dysfunction observed was restrictive 31 (88.5%), obstructive 2 (5.7%), and combined 2 (5.7%). A reduced forced vital capacity (FVC) % in 33 (73.3%), a reduced forced expiratory volume in the 1st second (FEV1%) in 25 (55.5%), a normal FEV1/FVC in 41 (91.2%), and a reduced FEF 25–75% in 23 (51.1%) children were observed. Risk factors such as, age, height, and duration of chelation (>5 years) were significantly associated with pulmonary dysfunction (P < 0.05). There was no correlation between serum ferritin levels and PFT. However, PFT values were found to be decreased in patients with a high serum ferritin (>2500 ng/ml), but these differences were statistically not significant. Abnormal patterns of lung function were common (restrictive type, predominant), even though none of these children had any respiratory symptoms.