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Respiratory function in patients with thalassaemia major: relation with iron overload
  1. A M Li1,
  2. D Chan1,
  3. C K Li1,
  4. E Wong2,
  5. Y L Chan3,
  6. T F Fok1
  1. 1Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR, China
  2. 2Centre for Clinical Trials and Epidemiological Research, The Chinese University of Hong Kong
  3. 3Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong
  1. Correspondence to:
    Dr A M Li, Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China;


Aims: (1) To determine the pattern of respiratory impairment in children with thalassaemia major (TM); (2) to assess the relation between the degree of respiratory impairment and total body iron content.

Methods: Twenty nine TM patients were recruited. All underwent physical examination, standardised pulmonary function tests (spirometry, lung volume, and single breath diffusion capacity for carbon monoxide), and magnetic resonance imaging measurements of the liver. Serum ferritin was measured. The signal intensity ratio of liver to that of paraspinal muscle (T1 weighted sequence) and serum ferritin were used as surrogate index of body iron content.

Results: Sixteen boys and 13 girls (median age 14.2 years) were studied. None had clinical evidence of congestive heart failure. Sixteen had normal lung function. Impairment of diffusion capacity (median DLco 83.5% predicted) was the most common abnormality, being observed in 34% of patients. Pure restrictive and obstructive ventilatory impairment was found in one and two patients respectively. Five patients had a combination of ventilation and diffusion defects. There was no correlation between the degree of impairment of each respiratory abnormality and body iron content.

Conclusion: Diffusion impairment was the commonest abnormality found in our cohort of paediatric TM patients. Our data did not support the notion that respiratory function impairment was correlated with body iron content.

  • pulmonary function test
  • thalassaemia
  • magnetic resonance imaging
  • ferritin
  • FEV1, forced expiratory volume in one second
  • FRC, functional residual capacity
  • FVC, forced vital capacity
  • MMEFR, maximum mid-expiratory flow rate
  • MRI, magnetic resonance imaging
  • ROI, region of interest
  • RV, residual volume
  • TLC, total lung capacity
  • TM, thalassaemia major

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