<![CDATA[Thalassemia is a genetic disorder that causes chronic anemia. While the thalassemia trait is typically mild, its severity can be amplified by coexisting conditions. This report discusses a unique case where thalassemia was complicated by peritoneal tuberculosis, leading to an unusually severe anemic state not typical for a carrier. A 15-year-old female undergoing treatment for peritoneal tuberculosis presented with severe anemia (Hemoglobin 7.43 g/dL). Physical examination revealed classic signs of thalassemia such as Cooley's facies and splenomegaly. Laboratory findings confirmed severe microcytic hypochromic anemia, and HPLC analysis showed elevated HbF and the presence of Hb Bart's, consistent with a thalassemia trait. The patient was managed with packed red cell (PRC) transfusions and folic acid, which successfully resolved the acute symptoms. The severe anemia in this patient was likely a result of multifactorial causes: an underlying thalassemia trait compounded by anemia of chronic disease (ACD) from tuberculosis. This case highlights the critical need to investigate for co-morbidities in thalassemia carriers with atypical presentations.]]>
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