Assessment of psychoneurological and intellectual function in patients with beta-thalassemia in Ismailia city

Abstract EN

Background: ^.Thalassemia is the commonest cause of transfusion dependent anemia in childhood." Over the years, several reports have demonstrated involvement of the nervous system in (S- thalassemia patients.

Neurological s: complications have been attributed to various factors such as chronic hypoxia, bone marrow expansion, iron overload, and desferoxamine neurotoxicity.

In most cases, neurological involvement is subclinical and can only be detected during neurophysiological or neuroimaging evaluation.

About 80% of thalassemia children had psychosocial problems.

These psychosocial problems have not been dealt deeply in research to the magnitude of importance in Egypt.

Aim s: To Assess the psychoneurological and intellectual function in patients with Beta-Thalassemia in Ismailia City Methods: 26 j3 thalassemic major children (mean age 10.2+4.36 years) attending the outpatient hematological pediatric clinic of Suez Canal university hospital.

A group of 26 normal children, matched for age and gender were included as a control group.

All patients were in a regular transfusion program, receiving subcutaneous desferoxamine chelation.

Assessment included history taking; psychosocial assessment was done by asking the parent to fill Child Behavior Checklist, Anxiety scale for children and Child Depression Inventory (CDI).

Patients underwent neurophysiology evaluation consisting of brainstem auditory, visual and somatosensory evoked potential examination (BAEP, VEP, SEP) as well as motor and sensory nerve conduction velocity studies (MCV, SCV).

Additionally, the verbal, performance and total IQ were assessed using the Weschler Intelligence Scale for Children (WISC- III).

Results: The incidence of abnormal BAEP, VEP, SEP and NCVs was 0, 7.7, 3.84 and 30.76%, respectively.

The prevalence of abnormal total IQ score was considerably high (38.46%), not correlating, however, to any of the parameters assessed (age, sex, ferritin level, BAEP, VEP, SEP, NCV).

Factors associated with chronic illness, rather than the disease per se, could play a potential role in the development of cognitive dysfunction in beta-thalassemia patients.

46.15% of thalassemic children have significant depression.

84.61% of them have significant anxiety.

Conclusion: Thalassemic children show significant number of internalizing problems and to less extent externalizing problems.

They suffer from learning difficulties and Impairment of social competence.