THERAPEUTIC TRIAL OF
EFFECTIVE ERYTHROPOIETIN SUPPRESSION IN CHILDREN AFFECTED WITH b-THALASSEMIA MAJOR : A
THREE–YEAR FOLLOW–UP
El-Nawawy A,
Marzouk S
El-Shatby
Children’s Hospital, Faculty of Medicine, Alexandria, Egypt
Objective: The
aim of the present study was to evaluate the efficacy of captopril in
inducing more effective suppression of erythropoiesis in children affected
with b-thalassemia
major
Methods: A
3 years follow-up study was conducted on 45 regularly transfused b-thalassemics
of which 23 cases were given captopril therapy (6.25-12.5mg b.i.d.). Twenty
age and sex matched controls were included at the end of the study. All
thalassemics were evaluated for their blood pressure (BP), hemoglobin (Hb),
blood urea, serum creatinine, alkaline phosphatase, alanine
aminotransferase, reticulocytic index (RI), serum ferritin, serum
erythropoietin (sEpo) and serum transferrin receptors (sTfr); at the start
and at the end of the study.
Results: Results
showed that subjects given captopril, after 3 years therapy, had lower
sEpo, sTfr and RI (31, 9, 1.41 versus 60 mU/ml, 16 ug/ml, 2.3
respectively); less incidence of splenomegaly (39 versus 77%); higher
height velocity and weight increments; compared to subjects without
captropril therapy.
Conclusion: Captropril
used in regularly transfused b-thalassemics could induce
better suppression of endogenous erythroropoiesis with a reasonable cost,
fair compliance and no side effects.