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What is the result of reduced or absent production of β-globin in individuals with β-thalassemia?
What is the result of reduced or absent production of β-globin in individuals with β-thalassemia?
What is the consequence of the α-globin to β-globin chain imbalance in β-thalassemia?
What is the consequence of the α-globin to β-globin chain imbalance in β-thalassemia?
What is the primary defect in β-thalassemia?
What is the primary defect in β-thalassemia?
What is the result of the accumulation of unpaired α-globin chains in red blood cell progenitor cells?
What is the result of the accumulation of unpaired α-globin chains in red blood cell progenitor cells?
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What is the genetic basis of β-thalassemia?
What is the genetic basis of β-thalassemia?
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What is a consequence of chronic hemolytic anemia?
What is a consequence of chronic hemolytic anemia?
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What is the primary reason for the development of chronic hemolytic anemia in individuals with β-thalassemia?
What is the primary reason for the development of chronic hemolytic anemia in individuals with β-thalassemia?
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What is a result of ineffective erythropoiesis in β-thalassemia patients?
What is a result of ineffective erythropoiesis in β-thalassemia patients?
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What is the consequence of the α-globin to β-globin chain imbalance in β-thalassemia?
What is the consequence of the α-globin to β-globin chain imbalance in β-thalassemia?
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What occurs in erythroid progenitor cells due to the unstable β-globin chains in dominant β-thalassemia?
What occurs in erythroid progenitor cells due to the unstable β-globin chains in dominant β-thalassemia?
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What is a cause of iron overload in β-thalassemia patients?
What is a cause of iron overload in β-thalassemia patients?
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What is the result of ineffective erythropoiesis in individuals with β-thalassemia?
What is the result of ineffective erythropoiesis in individuals with β-thalassemia?
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What is a complication of chronic hemolytic anemia?
What is a complication of chronic hemolytic anemia?
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What is the outcome of iron overload in individuals with β-thalassemia?
What is the outcome of iron overload in individuals with β-thalassemia?
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What is a result of extramedullary erythropoiesis?
What is a result of extramedullary erythropoiesis?
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What is the main consequence of qualitative defects that affect hemoglobin structure?
What is the main consequence of qualitative defects that affect hemoglobin structure?
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What is the estimated percentage of the global population that may carry a pathogenic variant affecting hemoglobin production?
What is the estimated percentage of the global population that may carry a pathogenic variant affecting hemoglobin production?
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What is the risk of having a child with a hemoglobin disorder for nearly 1 in 100 couples worldwide?
What is the risk of having a child with a hemoglobin disorder for nearly 1 in 100 couples worldwide?
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Which of the following is a common hemoglobin disorder?
Which of the following is a common hemoglobin disorder?
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How many pathogenic variants leading to abnormal globin subunits of hemoglobin have been described?
How many pathogenic variants leading to abnormal globin subunits of hemoglobin have been described?
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What is the consequence of inadequate hemoglobin production in individuals with thalassemia?
What is the consequence of inadequate hemoglobin production in individuals with thalassemia?
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What is the result of hemoglobin variants that disrupt the production or function of hemoglobin?
What is the result of hemoglobin variants that disrupt the production or function of hemoglobin?
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Which of the following is a characteristic of thalassemia syndromes?
Which of the following is a characteristic of thalassemia syndromes?
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What is the origin of the name 'thalassemia'?
What is the origin of the name 'thalassemia'?
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How are thalassemia syndromes named?
How are thalassemia syndromes named?
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What is the main characteristic of thalassemia syndromes?
What is the main characteristic of thalassemia syndromes?
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Which of the following regions is most prevalent for thalassemias?
Which of the following regions is most prevalent for thalassemias?
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What is the consequence of defect in the production of hemoglobin subunits in thalassemia?
What is the consequence of defect in the production of hemoglobin subunits in thalassemia?
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What is a common feature of patients with TDT?
What is a common feature of patients with TDT?
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What is the primary defect in thalassemia syndromes?
What is the primary defect in thalassemia syndromes?
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Which of the following is a consequence of chronic hemolytic anemia?
Which of the following is a consequence of chronic hemolytic anemia?
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What is the result of ineffective erythropoiesis in thalassemia patients?
What is the result of ineffective erythropoiesis in thalassemia patients?
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What is the main cause of hemolysis in thalassemia patients?
What is the main cause of hemolysis in thalassemia patients?
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What is the outcome of iron overload in individuals with thalassemia?
What is the outcome of iron overload in individuals with thalassemia?
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What is the primary feature of chronic hemolytic anemia?
What is the primary feature of chronic hemolytic anemia?
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What is the primary function of hemoglobin?
What is the primary function of hemoglobin?
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What is the term for the reversible binding of oxygen to hemoglobin?
What is the term for the reversible binding of oxygen to hemoglobin?
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What factors regulate the rate at which hemoglobin binds and releases oxygen?
What factors regulate the rate at which hemoglobin binds and releases oxygen?
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What is the name of the process by which hemoglobin releases oxygen to cells in the tissues?
What is the name of the process by which hemoglobin releases oxygen to cells in the tissues?
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What is the term for the amount of oxygen in the microenvironment?
What is the term for the amount of oxygen in the microenvironment?
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What is the primary outcome of the accumulation of unpaired α-globin chains in red blood cell progenitor cells?
What is the primary outcome of the accumulation of unpaired α-globin chains in red blood cell progenitor cells?
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Which of the following is a complication of chronic hemolytic anemia?
Which of the following is a complication of chronic hemolytic anemia?
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What is the primary cause of ineffective erythropoiesis in β-thalassemia patients?
What is the primary cause of ineffective erythropoiesis in β-thalassemia patients?
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What is the result of chronic hemolysis in β-thalassemia patients?
What is the result of chronic hemolysis in β-thalassemia patients?
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What is the primary consequence of iron overload in β-thalassemia patients?
What is the primary consequence of iron overload in β-thalassemia patients?
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What is the consequence of inadequate hemoglobin production in individuals with thalassemia?
What is the consequence of inadequate hemoglobin production in individuals with thalassemia?
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What is the result of ineffective erythropoiesis in thalassemia patients?
What is the result of ineffective erythropoiesis in thalassemia patients?
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What is a complication of chronic hemolytic anemia?
What is a complication of chronic hemolytic anemia?
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What is the result of iron overload in individuals with thalassemia?
What is the result of iron overload in individuals with thalassemia?
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What is the primary feature of chronic hemolytic anemia?
What is the primary feature of chronic hemolytic anemia?
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What is the primary response of the body to compensate for the deficient oxygen-carrying capacity of the blood in individuals with β-thalassemia?
What is the primary response of the body to compensate for the deficient oxygen-carrying capacity of the blood in individuals with β-thalassemia?
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What is the result of ineffective erythropoiesis in the bone marrow of individuals with β-thalassemia?
What is the result of ineffective erythropoiesis in the bone marrow of individuals with β-thalassemia?
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What is the primary cause of ineffective erythropoiesis in individuals with β-thalassemia?
What is the primary cause of ineffective erythropoiesis in individuals with β-thalassemia?
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What is the main consequence of iron overload in individuals with β-thalassemia?
What is the main consequence of iron overload in individuals with β-thalassemia?
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What is the outcome of chronic hemolytic anemia in individuals with β-thalassemia?
What is the outcome of chronic hemolytic anemia in individuals with β-thalassemia?
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What is the effect of α-globin to β-globin chain imbalance on erythropoiesis?
What is the effect of α-globin to β-globin chain imbalance on erythropoiesis?
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What is the primary consequence of chronic hemolytic anemia in individuals with β-thalassemia?
What is the primary consequence of chronic hemolytic anemia in individuals with β-thalassemia?
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What is the consequence of chronic hemolysis in individuals with β-thalassemia?
What is the consequence of chronic hemolysis in individuals with β-thalassemia?
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What is the primary cause of chronic hemolysis in individuals with β-thalassemia?
What is the primary cause of chronic hemolysis in individuals with β-thalassemia?
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What is the result of dominant β-thalassemia on hemoglobin production?
What is the result of dominant β-thalassemia on hemoglobin production?
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What is a possible consequence of ineffective erythropoiesis in β-thalassemia patients?
What is a possible consequence of ineffective erythropoiesis in β-thalassemia patients?
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What is a characteristic of individuals with β-thalassemia major?
What is a characteristic of individuals with β-thalassemia major?
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What may occur in individuals with β-thalassemia intermedia?
What may occur in individuals with β-thalassemia intermedia?
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What is a characteristic of chronic hemolytic anemia in β-thalassemia patients?
What is a characteristic of chronic hemolytic anemia in β-thalassemia patients?
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What is a complication of β-thalassemia?
What is a complication of β-thalassemia?
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What is the primary outcome of ineffective erythropoiesis in β-thalassemia patients?
What is the primary outcome of ineffective erythropoiesis in β-thalassemia patients?
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What is the primary cause of chronic hemolysis in β-thalassemia patients?
What is the primary cause of chronic hemolysis in β-thalassemia patients?
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What is the outcome of iron overload in β-thalassemia patients?
What is the outcome of iron overload in β-thalassemia patients?
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What is the primary consequence of chronic hemolytic anemia?
What is the primary consequence of chronic hemolytic anemia?
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What is the result of ineffective erythropoiesis in thalassemia patients?
What is the result of ineffective erythropoiesis in thalassemia patients?
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What is the primary consequence of ineffective erythropoiesis in β-thalassemia patients?
What is the primary consequence of ineffective erythropoiesis in β-thalassemia patients?
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What is a complication of chronic hemolytic anemia in β-thalassemia patients?
What is a complication of chronic hemolytic anemia in β-thalassemia patients?
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What is the primary cause of ineffective erythropoiesis in β-thalassemia patients?
What is the primary cause of ineffective erythropoiesis in β-thalassemia patients?
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What is the outcome of chronic hemolysis in β-thalassemia patients?
What is the outcome of chronic hemolysis in β-thalassemia patients?
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What is the primary feature of chronic hemolytic anemia in β-thalassemia patients?
What is the primary feature of chronic hemolytic anemia in β-thalassemia patients?
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What is the consequence of inadequate erythropoietin production in β-thalassemia patients?
What is the consequence of inadequate erythropoietin production in β-thalassemia patients?
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What is the primary cause of iron overload in β-thalassemia patients?
What is the primary cause of iron overload in β-thalassemia patients?
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What is the result of chronic hemolysis in β-thalassemia patients?
What is the result of chronic hemolysis in β-thalassemia patients?
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What is the consequence of ineffective erythropoiesis in β-thalassemia patients?
What is the consequence of ineffective erythropoiesis in β-thalassemia patients?
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What is a complication of ineffective erythropoiesis in β-thalassemia patients?
What is a complication of ineffective erythropoiesis in β-thalassemia patients?
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Study Notes
Chronic Hemolytic Anemia
- Chronic hemolytic anemia leads to chronic inadequate oxygenation of tissue due to premature red blood cell destruction.
- Red blood cell destruction occurs at a rate faster than the production of new red blood cells.
- This leads to reduced oxygen carrying capacity of the blood and resulting anemia.
Ineffective Erythropoiesis
- In β-thalassemia, the bone marrow responds to erythropoietin by increasing the production of erythroid progenitor cells.
- However, ineffective erythropoiesis leads to few mature red blood cells entering the peripheral circulation.
- The bone marrow becomes crowded with immature erythroid precursors.
Iron Overload
- Iron overload results in damage to involved cells and organs.
- Causes of iron overload include excessive iron absorption, ineffective erythropoiesis, and blood transfusions.
- Iron overload can contribute to heart failure, cirrhosis, liver cancer, growth retardation, and endocrine abnormalities.
β-Thalassemia
- The reduced or absent production of β-globin in individuals with β-thalassemia results in an excess of unpaired α-globin chains.
- The α-globin to β-globin chain imbalance drives the pathology of β-thalassemia.
- The pathologic outcomes of α-globin to β-globin chain imbalance produce chronic hemolytic anemia, ineffective erythropoiesis, and iron overload.
Thalassemia Syndromes
- Thalassemia syndromes are a diverse group of inherited anemia disorders characterized by reduced production of globin chains.
- The consequence of thalassemia is inadequate hemoglobin production, which can lead to a range of outcomes, from mild to severe.
- Thalassemias present with altered production of globin proteins, and the individual thalassemia syndrome is named according to the globin whose synthesis is affected.
Hemoglobin Disorders
- Hemoglobin disorders arise from either qualitative defects that affect hemoglobin structure (hemoglobinopathies) or quantitative alterations that reduce hemoglobin production (thalassemias).
- There are approximately 1400 pathogenic variants leading to abnormal globin subunits of hemoglobin.
- Nearly 1 in 100 couples across the world are at risk of having a child with a hemoglobin disorder.### Consequences of β-Thalassemia
- Chronic hemolytic anemia leads to chronic inadequate oxygenation of tissues due to premature red blood cell destruction, which occurs at a rate faster than the production of new red blood cells.
- Red blood cell destruction leads to reduced oxygen-carrying capacity of the blood, resulting in anemia.
- Chronic hemolytic anemia can lead to acute complications, such as gallstones, and long-term consequences, such as effects on growth, organ and vascular function, including heart enlargement and heart failure.
Ineffective Erythropoiesis
- In individuals with β-thalassemia, the bone marrow responds to erythropoietin production by increasing the production of erythroid progenitor cells.
- However, due to ineffective erythropoiesis, very few mature red blood cells make it into the peripheral circulation, and the bone marrow becomes crowded with immature erythroid precursors.
- Increased proliferation of erythroid progenitors in the bone marrow can lead to bone deformities and decreased bone mass.
Iron Overload
- Iron overload is the increase of iron in tissues, resulting in damage to involved cells and organs.
- Iron overload can be caused by excessive iron absorption, ineffective erythropoiesis, and chronic hemolysis.
- Iron overload may contribute to heart failure, cirrhosis, liver cancer, growth retardation, and endocrine abnormalities.
Classification of β-Thalassemia
- β-Thalassemia can be classified into three categories: β-thalassemia major, β-thalassemia intermedia, and β-thalassemia minor.
- β-Thalassemia major is typically classified as transfusion-dependent (TDT) and presents with severe anemia.
- β-Thalassemia intermedia is typically classified as non-transfusion-dependent (NTDT) and presents with mild to moderate anemia.
- β-Thalassemia minor is often asymptomatic or has very mild symptoms.
Clinical Presentation of β-Thalassemia
- TDT typically presents between 6 and 24 months of age, while more severe forms of NTDT typically present between the ages of 2 and 6 years.
- Patients with less severe forms of NTDT may be asymptomatic or present with mild symptoms.
- The main determinant in the clinical presentation and severity of β-thalassemia is the extent of α-globin to β-globin chain imbalance within the individual.
Genetic Background of β-Thalassemia
- β-Thalassemia is typically inherited in an autosomal recessive manner.
- Variants in the HBB gene, which makes β-globin, can cause β-thalassemia.
- The presence of HbS in patients with HbS/β-thalassemia results in sickle cell disease.
Epidemiology of β-Thalassemia
- β-Thalassemia is considered an orphan disease, or a rare disease that affects less than 200,000 people nationwide.
- The prevalence of β-thalassemia is expected to continue rising due to the increasing diversity of the population.
- The life expectancy for people with β-thalassemia can vary, depending on the specific type of β-thalassemia and access to medical care.
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Description
Learn about the consequences of β-thalassemia, including chronic hemolytic anemia, ineffective erythropoiesis, and iron overload. Understand how these outcomes affect the body and lead to chronic inadequate oxygenation of tissues.