Correlation between serum adenosine deaminase and serum elastase in patients with B thalassemia major

الملخص EN

Background : B– thalassemia is the commonest hemoglobinopathy in Egypt.

Blood transfusion and chelation therapy remains the mainstay of treatment in these patients.

Immune dysfunction in thalassemia patients is multifactorial.

Aim : The objective of this work was to find any possible correlation between serum adenosine deaminase and serum elastase in patients with B thalassemia major and to clarify whether alteration of adenosine deaminase level could be responsible for immunomodulation in patients with thalassemia major.

Methods : Twenty patients diagnosed as B_ thalassemia major were enrolled in the study as well as ten healthy individuals, age and sex matched, who served as control.

Hematological evaluation included complete blood picture, serum ferritin, fibrin degradation products.

Results : Estimation of serum adenosine deaminase and serum elastase showed a significant elevation of both serum adenosine deaminase and elastase in thalassemia patients compared to the control (t = 5.22, p <0.001, t = 6.588) nosine deaminase and elastase (r = 0.78, p = 0.001).

Also a significant elevation of total leucocyte and absolute neutrophilic counts in thalassemia patients was observed versus the control (t = 2.461, p = 0.02, t = 3.515, p = 0.002 respectively).

A higher mean absolute lymphocytic count was evident in patients yet it did not reach statistical significance.

This study has proved that up-regulation of adenosine deaminase counteracted the inhibitory effect of adenosine on neutrophilic activation.

Conclusions : adenosine deaminase could not be incriminated in immune dysfunction in thalassemia patients.

On the contrary, its high level was positively correlated with neutrophil activation evidenced by raised serum elastase level.