Background: Beta Thalassemia is inherited anemia characterized by absent or reduced
synthesis of β-globin chains of hemoglobin, caused by β-globin gene mutations resulting
in chronic hemolytic anemia that requires ‘repeated blood transfusion with resulting
iron overload’. Silymarin has iron chelating activity in thalassemic patients with iron overload.
Aim of the work: was to study the therapeutic value of combined therapy of Deferiprone
and silymarin as iron chelators in Egyptian children with beta thalassemia with
iron overload’. Patients and Methods: ‘This study was conducted on 80 beta thalassemic children with their
serum ferritin more than 1000 ng/ml who were divided into two groups’. Group I included 40 patients who
were treated with oral Deferiprone and silymarin for 9 months. Group II included 40 patients who were
treated with oral Deferiprone and placebo for 9 months. Results: ‘There were no significant differences in serum
ferritin, iron and TIBC between group I and group II before the study but after regular chelation therapy,
serum ferritin and iron were significantly lower in group I than group II. No statistically significant differences
in serum creatinine, blood urea, ALT, AST and bilirubin levels between Group I and Group II before
and after chelation therapy were observed’. Conclusion: Deferiprone in combination with silymarin are better
iron chelators than Deferiprone and placebo. Recommendations: ‘Extensive multicenter studies in large number
of patients with longer follow up period and more advanced methods of assessment of iron status to clarify
the exact role of silymarin in reduction of iron over load in thalassemic children’.
Keywords: Deferiprone, iron overload, silymarin, Thalassemia.
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