Alpha-thalassemia

Alpha-thalassemia silent carriers or patients with alpha-thalassemia trait do not require monitoring. However, practitioners should be aware that all thalassemia carriers, silent or mildly anemic, 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 anemia.

Patients with hemoglobin H (Hb H) disease should be monitored for the development of complications. Complications include episodes of severe anemia, 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 anemia that may require transfusion, and the fetus should be monitored for the development of hydrops fetalis.