Background: ‘Beta thalassemia is inherited hemoglobin disorder resulting in chronic
hemolytic anemia that requires lifelong transfusion therapy’. ‘Repeated blood transfusions and RBCs
hemolysis are the main causes of iron overload’, which in addition to immune abnormalities, are common
predisposing factors to infections in patients with thalassemia.
The Aim of this Work: The aim of this work was to study immune status including T lymphocyte subsets
and serum immunoglobulin levels ‘in children with beta- thalassemia in correlation with iron overload’.
Patients and Methods: The present ‘study was conducted on 40 children with beta thalassemia major
under follow up at Hematology Unit, Pediatric Department, Tanta University’ ‘including 24 males and 16
females with mean’ age value of 9. 22 ± 3.9 years and 20 ‘healthy children of matched age and sex as a
control group’. All children included in the study were subjected to; ‘complete blood count, Hb electrophoresis,
serum iron status’, T cell subsets including CD3, CD4 and CD8 and serum immunoglobulin
levels including IgM, IgA and IgG.
Results: ‘Pallor and jaundice were the most common presenting’ clinical manifestations. Infective
episodes ‘were significantly higher in patients’ compared with controls. There were significantly lower
Hb, MCV and MCH levels and significantly higher WBCs and platelets counts, reticulocytes and
lymphocytes percentage in patients than controls and no significant differences in MCHC between
patients and controls. Serum ferritin and iron were ‘significantly higher but TIBC was significantly lower
in’ patients than controls. CD3, CD4 and IgM were significantly lower but CD8, IgG, and IgA ‘were
significantly higher in patients than controls’ with negative correlation between CD3, CD4, IgM and
ferritin and positive correlation between CD8, IgG, IgA and ferritin.
Conclusion: Iron overload can affect humeral and cell mediated immunity in patients with beta
thalassemia with reduction of IgM, CD3 and CD4 and elevation of CD8, IgG, and IgA.
Recommendations: Regular follow up of patients with beta thalassemia for detection of iron overload as
it affects humeral and cell mediated immunity.