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Bulan Ginting Munthe
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The correlation between ferritin level and cardiac dysfunction in patients with thalassemia Fajar Subroto; Bulan Ginting Munthe; Najib Advani; Agus Firmansyah
Paediatrica Indonesiana Vol 43 No 1 (2003): January 2003
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (286.98 KB) | DOI: 10.14238/pi43.1.2003.24-7

Abstract

Background Patients with b-thalassemia major, long-term trans-fusion, extravasal hemolytic, and increased intestinal absorptionof iron result in systemic iron overload, which may accumulate inmyocardium causing cardiac dysfunctions. Congestive heart fail-ure usually develops in adolescence or early adult years, and pa-tient usually dies within 1 year after the onset of symptoms. There-fore, it is important to detect early signs of cardiac dysfunction inpatient with thalassemia.Objective This study aimed to assess the correlation betweenferritin level and cardiac dysfunction in patients with thalassemia.Methods A cross sectional study was conducted on 62 b-thalas-semic patients (34 males and 28 females) with age ranging from3.5 to 23 years. They received 3,150 – 94,985 mL of blood; withthe serum ferritin level of 812.2 – 12,175 ng/mL. Each patient un-derwent laboratory examinations and clinical cardiac evaluationwith ECG and echocardiography.Results Cumulative blood transfusions correlated well with theserum ferritin values (p=0.001). The serum ferritin level did notshow correlation with deferoxamine (DFO) treatment. ECG exami-nation revealed 5 patients (8.1%) with dysrhythmia, LVH, and heartblock grade II and I. Echocardiography examination showed 18patients (29%) with systolic or diastolic dysfunction. There was nocorrelation between the serum ferritin level and cardiac dysfunc-tions (p=0.640). The serum ferritin prediction value against car-diac dysfunctions could not be established.Conclusion There was no correlation between serum ferritin lev-els with cardiac dysfunctions. In detecting cardiac dysfunctions inthalassemic patients, echocardiography was more sensitive thanECG
Free testosterone level in patients with homozygous beta thalassemia on regular transfusions regimen Riadi Wirawan; Elly Santosa; Lyana Setiawan; Bulan Ginting Munthe; Dalima AW Astrawinata
Paediatrica Indonesiana Vol 44 No 2 (2004): March 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (453.514 KB) | DOI: 10.14238/pi44.2.2004.73-9

Abstract

Background Patients with homozygous beta thalassemia requireregular transfusions which will lead to iron deposition in tissuesincluding testicles.Objective This study aimed to evaluate testicular function in syn-thesizing testosterone by measuring free testosterone level. Thecorrelation between free testosterone level and transferrin satura-tion was evaluated.Methods This was a cross sectional study. Sampling was doneconsecutively. Free testosterone level was measured by radioim-munoassay in 20 homozygous beta thalassemic patients receiv-ing regular transfusions and compared to 20 healthy subjects.Results Fourteen out of 20 patients showed free testosterone levelbelow the reference range. Out of 20 thalassemic patients, onepatient’s serum was not enough for transferrin saturation determi-nation. Among the 19 patients, 18 had transferrin saturation above55%, 1 less than 55%, while all healthy subjects had normal trans-ferrin saturation. A significant difference was found between thetwo groups, both in the free testosterone level (p=0.001) and trans-ferrin saturation (p<0.001). A very weak correlation was found be-tween free testosterone level and transferrin saturation (r=-0.215).Conclusion We concluded that there might be a relationship be-tween iron overload and testicular endocrine function in patientswith homozygous beta thalassemia receiving regular transfusions
Splenectomy and its relation to non-transfusion-transmitted infection in thalassemic patients Mururul Aisyi; Alan Roland Tumbelaka; Bulan Ginting Munthe; Bambang Madiyono
Paediatrica Indonesiana Vol 46 No 3 (2006): May 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.3.2006.134-8

Abstract

Background Splenectomy has been associated with an increasedsusceptibility to infection. Overwhelming postspelenectomy infec-tion (OPSI) can lead to high mortality. Decreased IgM and tuftsinconcentration on splenectomized patients seems to play a role ininfection’s susceptibility. Many studies have been performed todetermine the risk factors of infection in thalassemic patients.Objective To find out morbidity patterns and risk factors for pre-dicting the likelihood of infection in splenectomized thalassemicpatients.Methods A retrospective cross sectional study was conducted onconfirmed thalassemic children who came to Department of ChildHealth, Cipto Mangunkusumo Hospital within the period of 1973-2003. Splenectomized patients were categorized as cases groupand non-splenectomized patients as control group. Risk factors fordevelopment of common cold and diarrhea were analyzed usingchi-square test with level of significance <0.05.Results A total of 300 thalassemic patients, 100 of them were sple-nectomized, were enrolled in this study. The 15-year-age group orabove is the most common group underwent splenectomy (35%).Common cold is the most common mild infection in both splenec-tomized group (75%) and non-splenectomized (71%). A significantassociation was found between the risk of infection and splenec-tomy in thalassemic patients (OR=3.8;CI=2.2;6.62; P=0.000). As-sociation between time after splenectomy and frequency of com-mon cold in thalassemia was significant (OR=2.85;CI=1.16;7.14;P=0.011). Severe infection and acute diarrhea were considerednot significantly different between the two groups.Conclusion Splenectomy in thalassemia can increase the sus-ceptibility of non-transfusion-transmitted mild infection. Furtherstudy is needed to elaborate this finding
Co-Authors Agus Firmansyah Alan Roland Tumbelaka Bambang Madiyono Dalima AW Astrawinata Elly Santosa Fajar Subroto Lyana Setiawan Mururul Aisyi Najib Advani Riadi Wirawan