Thalassemia major is also called Cooley's anemia and
Mediterranean anemia. It is found in people with ancestry tracing to northern
Africa, southern Europe, and such Asian areas as Iran, Iraq, Indonesia,
Thailand, and southern China. It is a serious disease which starts in early
life. In addition to the usual symptoms of anemia plus the jaundice of the
hemolytic type, there is enlargement of liver and spleen. During the course of
it, there may develop leg ulcers, gallstones, and a type of heart failure that
is resistant to therapy. In thalassemia minor, the anemia is mild and the
outlook very good.
Life span is normal. Usually no treatment is needed except
possibly in pregnancy when blood transfusion may be used to keep the blood
hemoglobin level at a safe point for the sake of mother and child. There are
many other types of anemia, relatively rare, in which some slight abnormality
of chemical structure of hemoglobin is the basic fault. Usually, when such
anemias are suspected, study by a specialist in blood diseases, a hematologist,
is needed. Other types of hemolytic anemia which usually require attention of a
blood specialist for diagnosis and follow-up are autoimmune hemolytic anemia,
ovalocytosis, paroxysmal nocturnal hemoglobinuria, and prima equine-sensitive
hemolytic anemia.
The latter disease, which occurs in 10 to 15 percent of
black males and 1 to 2 per- cent of black females, involves an unusual
sensitivity to certain medications and chemicals; it usually clears up as soon
as the offending substances are eliminated. Plastic Anemia Since blood cells
are manufactured in the bone marrow; anemia may result when the marrow is
damaged and becomes sluggish or fails to function at all. In this type of
anemia, not only are red blood cells reduced in numbers; so, too, are the whitecells. Resistance to infections is thus reduced, too.
Blood platelet count drops as well and thus there may be
bleeding. When aplastic anemia is severe, the outlook is grave. The mortality
rate may go as high as 50 percent. With good treatment, the remaining 50 per-
cent sometimes do quite well and, fortunately, in some cases, the disease
clears up spontaneously. Aplastic anemia may be a result of sensitivity or
toxic reaction to many medications and chemicals, including chloromycetin, Butazolidin,
Mesantoin, benzene, hair dyes, volatile solvents, and insecticides.
Irradiation in large doses also may be responsible.
