Alpha-thalassaemia

Alpha-thalassaemia silent carriers or patients with alpha-thalassaemia trait do not require monitoring. However, practitioners should be aware that all thalassaemia carriers, silent or mildly anaemic, should not be treated with iron therapy unless their low iron status is proved. Conversely, these patients may respond to folic acid supplementation with improvement in their anaemia.

Patients with haemoglobin H (Hb H) disease should be monitored for the development of complications. Complications include episodes of severe anaemia, cholelithiasis, ulcers, osteopenia, and growth retardation. They should also be monitored carefully for the development of iron overload, even in the absence of chronic transfusions.

Pregnant patients with Hb H should also be followed carefully for worsening anaemia that may require transfusion, and the fetus should be monitored for the development of hydrops fetalis.