Incidence, characteristics and laboratory parameters of epistaxis in children with β-Thalassemia major at a Tertiary Care Hospital of South Punjab, Pakistan.

Objective: To find out the incidence, characteristics and laboratory parameters of epistaxis in children with β-thalassemia major visiting a tertiary healthcare facility of South Punjab, Pakistan. Study Design: Retrospective study. Setting: Department of Hematological Disorder, Thalassemia and Bone Marrow Transplantation Centre, and Department of Biochemistry, Bahawal Victoria Hospital, Quaid e Azam Medical College, Bahawalpur, Pakistan. Period: January 2021 to November 2022. Material & Methods: The hospital record of children of both genders aged from 2 to 18 years of age with blood transfusion dependent β-thalassemia was analyzed. Children reporting at least 1 episode of epistaxis in the preceding period were included in the final analysis to find out the incidence, characteristics and laboratory findings of children presenting with of epistaxis. Results: Out of 3772 children with β-thalassemia major, 85 reported at least 1 episode of epistaxis showing the incidence of epistaxis as 22.5/1,000 cases of β-thalassemia major. The mean age of the children at the time of enrollment and at the time of diagnosis of thalassemia was 9.93±3.48 years and 1.23±1.26 years respectively. The mean monthly frequency of blood transfusion was 1.71±0.75 blood transfusions per month. The mean monthly epistaxis frequency was reported to be 2.35±1.71 while 59 (69.4%) children had 2 or more than 2 monthly episodes of epistaxis. The mean serum ferritin level was noted to be 4058±2173 ng/ml. Ultrasonography findings revealed mean spleen size to be 9.25±5.80 cm. Conclusion: The incidence of epistaxis episodes among children with β-thalassemia was very high. Chronic iron-overload seemed to be common abnormality among children with β-thalassemia that should be addressed to potentially reduce the risk of epistaxis among these children.