Cryoglobulinemia in transfusion-dependent thalassemia major

OBJECTIVE: The aim of this study was to determine the frequency of cryoglobulinemia and associated symptoms in transfusion-dependent thalassemia patients at high risk for HCV infection.

METHODS: A controlled epidemiological study was used to evaluate the prevalence of clinical, biochemical and immunological abnormalities in a group of 264 HCV-positive and 106 HCV-negative transfusion-dependent thalassemia patients. Haematologic and hepatic function tests were performed according to standard methods. HCV-RNA was detected by PCR analysis.

RESULTS: The significant presence of cryoglobulinemia and associated symptoms (purpura, vasculitis, arthritis, asthenia, proteinuria), serum autoantibodies (SMA, anti-GOR, ANA, LKM), low complement and rheumatoid factor were found in HCV-positive compared with HCV-negative patients.

CONCLUSIONS: This study demonstrates the role of HCV in inducing cryoglobulinemia and immunological disorders in transfusion-dependent thalassemia patients. HCV infection and associated immune abnormalities are a new clinical aspect of, and deserve particular attention due to their high frequency in, transfusion-dependent thalassemia patients.