HAEMATOLOGICAL (CBC) AND HEPATOLOGICAL (LFT) STATUS OF BETA THALASSEMIA MAJOR PATIENTS IN DHQ HOSPITAL, MIRPUR, AZAD JAMMU AND KASHMIR: COMPARATIVE ANALYSIS

Abstract

Background: β-thalassemia major (β-TM) is an inherited disorder of β-globin synthesis that causes severe anemia and requires lifelong red cell transfusion. Repeated transfusion leads to iron overload that damages the liver and other organs. Pakistan carries one of the highest burdens of β-TM worldwide, yet no study has described the laboratory profile of patients in Mirpur, Azad Jammu and Kashmir (AJK).

Objective: To compare the hematological (complete blood count, CBC) and Hepatological (liver function test, LFT) profiles of transfusion-dependent β-TM patients with those of age- and sex-matched healthy individuals.

Methods: This comparative cross-sectional study enrolled 50 previously diagnosed β-TM patients (25 male, 25 females; age 1–26 years; hepatitis B and C negative) attending the Thalassemia Department of the District Headquarters (DHQ) Hospital, Mirpur, and 50 healthy controls matched for age and sex. CBC was measured on an automated three-part hematology analyzer (Mindray BC-3000 Plus), and alanine aminotransferase (ALT), alkaline phosphatase (ALP) and total serum bilirubin (TSB) on a semiautomated biochemistry analyzer (Microlab 300). Groups were compared using Welch's two-sample t-test (p < 0.05).

Results: Most participants (58%) were aged 1–9 years. Compared with controls, patients had significantly lower hemoglobin (7.30 ± 1.64 vs 13.29 ± 1.08 g/dL), red cell count (3.15 ± 0.76 vs 4.91 ± 0.39 ×10⁶/µL), hematocrit (23.94 ± 5.49 vs 39.29 ± 2.93%), MCV (76.33 ± 3.81 vs 80.75 ± 3.42 fL) and MCH (26.89 ± 2.15 vs 28.91 ± 1.50 pg) (all p < 0.001), and significantly higher WBC (11.18 ± 7.98 vs 7.45 ± 1.89 ×10³/µL; p = 0.002), platelets (392.06 ± 169.57 vs 263.58 ± 78.93 ×10³/µL; p < 0.001) and MCHC (34.78 ± 0.84 vs 33.77 ± 0.90 g/dL; p < 0.001). All liver parameters were raised in patients: TSB: 1.91 ± 1.22 vs 0.71 ± 0.09 mg/dL, ALT: 72.54 ± 55.52 vs 27.78 ± 8.67 U/L and ALP: 380.18 ± 136.51 vs 150.66 ± 42.38 U/L (all p < 0.001). The same pattern was present in both sexes.

Conclusion: Transfusion-dependent β-TM patients in Mirpur show marked anemia despite regular transfusion, together with biochemical evidence of hepatic stress. Routine monitoring of CBC and LFTs, alongside iron status assessment, should be an integral part of their care, and community awareness and carrier screening should be strengthened.