Protocols - Hemorio

MAJOR AND INTERMIDIATE THALASSEMIA
DIAGNOSTIC EXAMS
- Peripheral blood study + complete red blood cell (VCM e CHM) + retyculocytes
- Hb A2 dosage and fetal
- Osmotic fragile curve
- Family Study (parent and siblings)
MAJOR THALASSEMIAX INTERMEDIATE THALASSEMIA
- MAJOR – Hb maintenance < 7g/dL
- INTERMEDIATE - Hb maintenance > 8g/dL
PERIODIC CONTROL
DIAGNOSE
QUARTER
SEMESTRAL
ANNUAL
- Conduct to Interdisciplinary Group of Thalassemia treatment
- Immunhematologic study (phenotype)
- Serology (hepatitis A,B,C, HIV, HTLV, CMV)
- Vaccination for hepatitis B (depend on serology)
- PPD (for non reactors)
- Medical consultation
- ferrokinetics (ferritine, TIBC)
- Glucose, urea, creatinine, LDH
- TGO, TGP, FAL, gamma-GT
Cardiologic Evaluation
- Echocardiogram
- ECG (12-lead)
- Chest x-ray
Serologic Evaluation
- Hepatitis: A (anti HAV – IgG) / B (HBSAg, Anti HBS and anti HBC IgG / C (Anti
HCV)
- Retrovirus (Anti HIV, Anti HTLV)
Evaluation of growth curve (compare to parent and siblings height)
- Graphics Age X Weight X Height
- Accurate measurement of height (stand and sit positions)
Thyroid Evaluation (as of 12 years)
- Free TRH, T4 and TSH
Parathyroid Evaluation (as of 16 years)
- Calcium
- Phosphate serum
- PTH
Other hormonal evaluations
- LH / FSH
- Testosterone
- Estradiol
- cortisol on morning fasting
Tanner staging of puberty
Ophthalmological Evaluation - Campimeter and Fundus of eyes
Audiometric Evaluation
- Oral glucose tolerance test
- Fist and hand x-rays
- Densitometry or bone x-ray
- Cholesterol total, HDL and triglyceride
- RNM T2* (hepatic and cardiac evaluation)
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