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Key Points

* Thalassemias are inherited blood disorders. "Inherited" means they're passed on from parents to children.
* Thalassemias cause the body to make fewer healthy red blood cells and less hemoglobin than normal.
* People who have thalassemias can have mild or severe anemia. This condition is caused by a lower than normal number of red blood cells or not enough hemoglobin in the red blood cells.
* The two major types of thalassemia are alpha thalassemia and beta thalassemia. There are different forms of each type.
* Thalassemias occur when the genes that control the production of hemoglobin are missing or altered. Your body won't work properly if your red blood cells don't make enough healthy hemoglobin.
* Family history and ancestry are the two risk factors for thalassemias. If your parents have missing or altered hemoglobin-making genes, you may have thalassemia. Thalassemias occur most often among people of Italian, Greek, Middle Eastern, Asian, and African descent.
* Signs and symptoms of thalassemias are due to lack of oxygen in the bloodstream. They may include mild to severe anemia; slowed growth and delayed puberty; bone problems; and enlarged spleen, liver, or heart; a pale and listless appearance; poor appetite; dark urine; and jaundice (a yellowish color of the skin or whites of the eyes). Symptoms depend on the type of thalassemia you have. Silent carriers have no symptoms.
* Doctors diagnose thalassemias using blood tests, including a complete blood count and special hemoglobin tests. Prenatal testing can show whether an unborn baby has thalassemia and how severe it's likely to be.
* People who have mild thalassemia often need little or no treatment. There are three standard treatments for moderate and severe forms of thalassemia. These include blood transfusions, iron chelation therapy, and folic acid supplements.
* Better treatments now allow people who have moderate and severe thalassemias to live much longer. As a result, these people must cope with complications of the disease that develop over time. Complications include heart and liver disease, infections, osteoporosis, and other problems.
* Thalassemias can't be prevented because they're inherited. However, these blood disorders can be found before birth through prenatal testing.
* Living with thalassemia can be challenging, but several approaches can help you cope. Follow your doctor's treatment plan, get ongoing medical care, take measures to stay healthy, and seek help and support.

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Thalassemia Minor: Understanding the Silent Carrier

Introduction: Thalassemia is a genetic blood disorder characterized by abnormal hemoglobin production, leading to anemia. Thalassemia minor, also known as thalassemia trait or carrier state, is the mildest form of thalassemia. Individuals with thalassemia minor typically have one normal hemoglobin gene and one mutated hemoglobin gene. Although it is considered a mild condition, understanding thalassemia minor is crucial due to its implications for genetic counseling and potential complications during pregnancy. Genetic Basis and Inheritance: Thalassemia minor is inherited in an autosomal recessive manner, meaning that both parents must carry the gene mutation for their child to have thalassemia minor. The mutated genes affect the production of either the alpha or beta globin chains that make up hemoglobin, the protein responsible for carrying oxygen in the blood. The severity of thalassemia is influenced by the specific gene mutation and the extent to which the normal gene is affected.

Diagnosis

Thalassemia can be diagnosed in different ways. Some types can be found on routine blood tests that show that the red blood cells are small or the patient is anemic. Testing of parents can be done before pregnancy to determine whether there is a risk of having a child with a severe form of thalassemia. The illness can be seen in sophisticated genetic testing, and can be found prenatally through amniocentesis or chorionic villus sampling (CVS).

Alpha Thalassemias

Four genes (two from each parent) are needed to make enough alpha globin protein chains. If one or more of the genes is missing, you will have alpha thalassemia trait or disease. This means that you don't make enough alpha globin protein. * If you have only one missing gene, you're a silent carrier and won't have any signs of illness. * If you have two missing genes, you have alpha thalassemia trait (also called alpha thalassemia minor). You may have mild anemia. * If you have three missing genes, you likely will have hemoglobin H disease (which a blood test can detect). This form of thalassemia causes moderate to severe anemia. Very rarely, a baby will have all four genes missing. This condition is called alpha thalassemia major or hydrops fetalis. Babies with hydrops fetalis usually die before or shortly after birth.