Are there other variables?

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Offline Manal

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Are there other variables?
« on: December 23, 2006, 02:59:49 AM »
Hi

Are there any other variables that has to do with bone deformation than HB levels? I ask this question because there is a child exactly the same case as my son ( thal intermedia, never transfused, HB in the sixs,... ). This child is 2.5 years and my son is 4.3 years. This child has a slight deformation in the forehead that is noticable, while my son (till now, thanks to GOD) has not shown anything deformed yet. So what may be a cause for this rather than HB as they are almost the same levels??

Does bone deformation, cause the skin to bruise? Of course, i know that deformation doesn't happen in days but it can take months or even years but are they preceded with bruises???

Also, the bones doctor ( i don't know the medical term ) told me to avoid having my son strongly hit (like in group sports) cause this may cause bleeding under the skin and that is not good for thal. The visit was messy and i forgot to ask him why, so anybody knows why is that???

Hope i am understood and sorry for too much questions ???

Manal

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Offline Andy Battaglia

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Re: Are there other variables?
« Reply #1 on: December 23, 2006, 07:54:40 AM »
Hi Manal,

The bone deformation is caused by expansion of the bone marrow. I would suggest that the other child's bone marrow has to work harder to keep that Hb level, than your son's does. The designation of intermedia can be very subjective and almost arbitrary and using that diagnosis by Hb level alone may be a mistake. Bone deformation can be prevented by transfusion and it may mean that child should be transfusing. For this to be apparent at age 2, it does seem that the child has more characteristics of major than intermedia and probably should be transfused before more deformation takes place. However, doctors treat intermedia very differently from place to place, so the child's doctor may not agree.

If it is available, a bone density scan would give a more accurate view of the condition of your son's bones. In addition to the possibility of bleeding, contact sports can pose a danger to thals who do not have strong bones. Some thals are able to play contact sports but often, the bones are more brittle than normal and break easily and heal slowly. The bleeding is usually related to low platelets and/or a vitamin C deficiency, which is often a problem in thals as they should only take small amounts of C because high levels release too much iron at one time into the blood where it can clump in the heart and weaken heart function. Thalassemia causes much stress on the body which lead to deficiencies of many vitamins, such as E, C and folic acid. But since thals can't use high amounts of C they will sometimes suffer from deficiency which can't easily be corrected without posing some danger to the heart. Vitamin C deficiency can be seen first in how easily a person bruises. Because of the deficiency, the capillary walls are weak and break easily, leading to bruising. This, along with the low platelet levels that care sometimes seen in thals, are both possible factors in bleeding under the skin.
Andy

All we are saying is give thals a chance.

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Offline Manal

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Re: Are there other variables?
« Reply #2 on: December 23, 2006, 10:52:34 AM »
Thanks Andy a lot for the reply. Its is very clear as usual. :thumbsup

Concerning the bone density scan, i did one for my son but it seems to be useless because my son age at the time of scan was 3.9 years and the smallest age they have for a normal refrence is 6 years. So i have his numbers but i don't have his same age refrence to compare to in order to know if the density of his bones are/are not normal to his age

Thanks
Manal

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Offline Andy Battaglia

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Re: Are there other variables?
« Reply #3 on: December 23, 2006, 05:54:04 PM »
Hi Manal,

There was some value to your son's bone scan because now there is a reference point for future scans.
Andy

All we are saying is give thals a chance.

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Offline Manal

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Re: Are there other variables?
« Reply #4 on: December 23, 2006, 11:34:39 PM »
Hi Andy

Sorry i didn't understand. Do you mean that the scan i did at the age if 3.9 would be my refrence that i will compare to in future scans??

Manal

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Offline Andy Battaglia

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Re: Are there other variables?
« Reply #5 on: December 23, 2006, 11:38:17 PM »
Yes, it gives a reference point for comparison in future scans for your son. It also adds to the limited data base of young children who have had bone scans and may prove of some use to future patients, just as we are attempting to accomplish by our questions about young children using exjade. The knowledge we develop here can be of great use to doctors who have no prior experience administering exjade to children.
Andy

All we are saying is give thals a chance.

 

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