Summary
Definition
History and exam
Key diagnostic factors
- country of origin or ancestry
- family history
- asymptomatic
Other diagnostic factors
- lethargy
- abdominal distension
- failure to gain weight
- low height and weight
- pallor
- spinal changes
- large head
- chipmunk facies
- misaligned teeth
- hepatosplenomegaly
- jaundice
Risk factors
- positive family history
Diagnostic tests
1st tests to order
- CBC
- peripheral smear
- reticulocyte count
- hemoglobin analysis
- LFTs
- plain x-rays of skull
- abdominal ultrasonography
- plain x-rays of long bones
Tests to consider
- genetic testing
- HLA typing
Treatment algorithm
beta-thalassemia trait
beta-thalassemia intermedia: non-transfusion-dependent
beta-thalassemia intermedia: transfusion-dependent
beta-thalassemia major
Contributors
Authors
Sujit Sheth, MD
Professor of Clinical Pediatrics
Weill-Cornell Medical College
New York
NY
Disclosures
SS is a consultant for Bristol Myers Squibb (formerly Celgene), manufacturer of luspatercept; for Bluebirdbio, developer of a gene therapy product for transfusion dependent beta-thalassemia; and for Agios, related to mitapivat for thalassemia. Steering committee member for CTX001, gene editing product by CRISPR/Vertex. Participation in multicenter trials conducted by LaJolla, Bristol Myers Squibb, Terumo, Novartis, Dispersol. SS is also an author of references cited in this topic.
Peer reviewers
Christoph Pechlaner, MD
Associate Professor of Medicine
Innsbruck Medical University
Innsbruck
Austria
Disclosures
CP declares that he has no competing interests.
Michael R. Jeng, MD
Associate Professor
Pediatric Hematology & Oncology
Stanford University School of Medicine
Palo Alto
CA
Disclosures
MRJ declares that he has no competing interests.
Differentials
- Congenital dyserythropoietic anemia (CDA)
- Pyruvate kinase (PK) deficiency
- Mild iron deficiency anemia
More DifferentialsGuidelines
- Carrier screening in the age of genomic medicine
- Carrier screening for genetic conditions
More Guidelines- Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer