Study of Pulmonary Function Tests in Multitransfused Children with Thalassaemia: A Case-control Study

Abstract

Introduction: Lung involvement is one of the known complications of thalassaemia. This study was undertaken to assess the predominant type of pulmonary dysfunction. Most studies show pulmonary function abnormalities but the results are conflicting. Aim: To study Pulmonary Function Tests (PFTs) in multitransfused children with thalassaemia and compare them with normal children. Materials and Methods: This was a case-control study conducted from May 2012 to June 2013 at MS Ramaiah Medical College, Bengaluru, Karnataka, India, which included 35 children in the age group of 3-16 years with β-thalassaemia major and on regular transfusion as cases and 35 age and sex matched healthy children participated as controls. PFTs were done in 35 children with β-thalassaemia major, using Spirobank G and within three days of blood transfusion. Following parameters were recorded: Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), Ratio of Forced Expiratory Volume in 1 second to Forced Vital Capacity (FEV1/FVC), Peak Expiratory Flow Rate (PEFR), and Forced Expiratory Flow (FEF25%-75). Student’s’ test was used for statistical analysis. Results: Percentage abnormalities of PFT in thalassaemia children were observed, 20 (57.14%) children had normal PFTs. Among the remaining children 9 (25.71%), 5 (14.29%) and 1 (2.86%) had restrictive, obstructive and mixed pattern of abnormalities respectively. Conclusion: Pulmonary function appeared to be affected in a majority of subjects with thalassaemia. Abnormal patterns of lung function were common in which restrictive type was predominant. No respiratory symptoms was found in any of these children. Studies are needed to establish the precise cause of pulmonary dysfunction.