This 10 years old child is confirmed case of thalassemia & has been admitted for blood transfusion. 2 questions: What are the facial features you can note in this patient? When will he require to have iron chelation therapy?

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Classical thalassemic facies / chipmunk facies / rhodent facies . Due to hypertrophy erythroid hyperplasia of marrow . Malocclusion of teeth can lead to dental caries n periodontal disease . Frontal bossing maxillary hyperplasia .

EXTRA MEDULLARY ERYTHROPOIESIS..
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Features; frontal bossing, prominent facial bones, dental malocclusion. Chelating therapy is usually started 1-2yr of transfusions when ferritin level is 1000-1500 ug/l. Deferoxamine 40-60mg/kg/day is infused over 8-12hrs during night for 5-6days a week

I agree with the treatment.
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Frontal bossing,malaria prominence,teeth malplacement,sparse hair, all compatible with thalassemia. Chelation be started ferritin level 1000mcg/ml.Drugs available are desferrioxime IV/SC(usually preferred), deferipone,defrasirox.May be given in combinations, to reduce cost or complication

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Chipmunk facies : frontal bossing, malar hyperplasia, flattening of nasal bridge, dental malocclusion. Due to repeated blood transfusions when the serum ferritin levels reach 1000-1500iu/l iron chelation is required.

I agree with Dr. Dr. Nitesh

Thank u sir
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Frontal bossing, maxillary bone prominence, upper lip Eventration, malocclusion. Chelation is regularly indicated. After each blood transfusion. Now treated RBC are transfussed to maintain Hb 10gmper dl. No to whole blood transfusion.

Maxillary n frontal prominences, saddle nose , all narrow spaces enlarged .. chelate wid desferoxamine.if ferritin more than 1500 u can start I v desferritin subcutaneous infusion to reduce cardiac load

Typical thalessemic facies /mongoloid face frontal bossing, malar prominence, depressed nasal bridge,, prominent maxilla, dental malocclusion present. For iron chelation. Drugs like defersirox, deferoxamine can b given.

Classical thalassemic favies /chipmunk facies or rhodent faceies.. ->Frotal boosing ->Malar prominence ->Malocclusion of teeth

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