الفهرس 
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Abstract
Iron-induced oxidative stress in thalassemic children can initiate tissue injury and/or inflammation. Elevated serum levels of C-reactive protein (CRP) have been considered to be non-specific but sensitive markers of the acute inflammatory response. However, IMA is not a signal protein and not generated in pro-inflammatory state alone but rather an end product of oxidative stress. Our study was done to evaluate ischemia modified albumin and C-reactive protein in thalassemic children and their relation to iron chelation therapies. Our study was carried upon: Group 1: included 60 patients already diagnosed as β- thalassemia major who had regular follow up in pediatric Hematology outpatient ҆ s clinic with an age ranged from 5 to 16 years and Group 2: included 20 apparently healthy children serving as normal control matching age and sex with patients with thalassemia major. The study revealed the following results: A significant differences in serum ferritin and IMA levels between thalassemic children on chelation therapy either on DFP or DFX and thalassemic children not receiving iron chelation therapy. A significant differences in serum CRP level was only found between thalassemic children receiving DFX and thalassemic children not receiving any chelation therapy at all. There was a significant positive correlation between serum ferritin and both CRP and IMA levels in thalassemic children. Also, there was a significant positive correlations between IMA and CRP levels in thalassemic children. In conclusion, our study revealed that CRP and IMA levels were higher in thalassemic children than controls. Also, there was a significant decrease in serum ferritin, CRP and IMA levels in β-thalassemia children on chelation therapy than thalassemic children not receiving any iron chelation therapy. Recommendations: Estimation of IMA and CRP levels can be used to assess oxidative and inflammatory stressors thalassemic children are exposed to. According to our study we can recommend anti-oxidants as a line of treatment for improving the prognosis in thalassemic patients. More studies are needed for further investigate the effect of DFX on inflammation in thalassemic children. More studies are needed to evaluate relation of CRP to thromboembolic tendency in thalassemia major. Further stress on the importance of proper, adequate and early start of chelation therapy in thalassemic patients.