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General Updates | Managing acute complications of thalassemia that may present to the emergency department
In this video, Ali Taher, MD, PhD, FRCP, American University of Beirut Medical Center, Beirut, Lebanon, outlines the acute complications of thalassemia that may present to the emergency department, including symptomatic anemia, cardiac decompensation, thromboembolic events, transfusion-related reactions, and infections. Prof. Taher emphasizes the importance of prompt recognition, early consultation with specialists, and appropriate management protocols to improve patient outcomes, highlighting the need for increased awareness and training among emergency care providers to recognize and manage β-thalassemia-related emergencies. Prof. Taher signposts these professionals to the recently published practical guide to thalassemia care in the emergency department, available here: https://pubmed.ncbi.nlm.nih.gov/40769855/. This interview took place virtually.
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Transcript
I think this question needs several hours to discuss; however, I’ve tried to summarize the main concepts and for sure you could go through the last review that we have done on approach to thalassemia in the emergency room.
So the common presentations would include symptomatic anemia, cardiac decompensation, thromboembolic events, infections, severe infections, transfusion-related reactions...
I think this question needs several hours to discuss; however, I’ve tried to summarize the main concepts and for sure you could go through the last review that we have done on approach to thalassemia in the emergency room.
So the common presentations would include symptomatic anemia, cardiac decompensation, thromboembolic events, infections, severe infections, transfusion-related reactions. The cardiac complications would range between arrhythmia due to iron cardiomyopathy, leading to the major cause of mortality, and that would require urgent intervention started in the emergency room.
Pulmonary hypertension, high output heart failure, and thromboembolic events also are relevant in non-transfusion-dependent patients that present to the emergency room, especially if they are splenectomized.
Infections, especially those that do not have a spleen because they are splenectomized, and these would require empiric antibiotics as early as possible if they present to the emergency room and for sure taking care of the thromboembolic event during that increase in splenectomized patients.
Sometimes neurological presentations such as spinal cord compression, which is really very important, or stroke, they might be under-recognized in the emergency room and require imaging and multidisciplinary care.
Renal dysfunction, leg ulcers, gallbladder stones are also sometimes a presentation, but not as acute as what I have discussed previously.
So in the emergency room, there should be prompt recognition, appropriate diagnosis, early consultation of the hematologist, cardiologist, infectious disease, and the surgical team when these patients present to the emergency room. And also we need to incorporate transfusion protocols, chelation adjustment, and disposition planning, which is really important for continuing care. So by increasing awareness and training, the emergency doctors will provide, can significantly impact outcomes of our patients with thalassemia. I think it’s really very important to read this review because it goes through the details of each one of the complications that I have mentioned in this presentation.
This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.
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