Recognize the types of thalassemia minor and major, and the differences between the two

Thalassemia is a blood disorder that is hereditary. This disease causes sufferers to experience symptoms of anemia or anemia. The most common types of thalassemia are major and minor. What is the difference between major and minor thalassemia? Which of the two is heavier?

What are the types of thalassemia?

Thalassemia is caused by mutations in the gene responsible for producing hemoglobin. Hemoglobin is a substance found in red blood cells with the function of carrying oxygen throughout the body. This hemoglobin consists of a chain arrangement called alpha and beta.

Generally, there are several divisions of the types of thalassemia. Based on the severity, this disease is divided into thalassemia major, intermedia, and minor.

Based on the arrangement of the chain that is damaged, thalassemia is divided into alpha thalassemia and beta thalassemia. How much damage occurs determines the severity and is the difference between major and minor thalassemia.

1. Thalassemia minor

Thalassemia minor is a condition when the number of alpha or beta chains is reduced only slightly. Therefore, the symptoms of anemia shown by people with thalassemia minor are generally mild, even absent in some cases.

Even though thalassemia minor has mild anemia symptoms, or doesn't even show any symptoms, people with it can still pass the disease or problematic genes to their children later. Therefore, it is necessary to take certain precautions to minimize the chances of having a child with thalassemia.

Alpha thalassemia minor

In the case of alpha, thalassemia can be classified as a minor type if there are two genes that are missing in the formation of alpha chains in hemoglobin. Under normal conditions, the body should have four genes to form alpha chains.

Beta minor thalassemia

Meanwhile, the number of genes that are normally required to compose the beta chain is 2. If one of the two genes forming the beta chain is problematic, the condition is classified as minor type thalassemia.

2. Thalassemia intermedia

Thalassemia intermedia is a condition when a patient experiences symptoms of anemia of moderate severity.

According to the American Family Physician, alpha thalassemia patients with the intermedia type lose 3 of their 4 alpha chain genes. Meanwhile, intermedia beta thalassemia occurs when 2 of the 2 beta chain genes are damaged.

This disease is usually detected only in older children. Most of the intermedia thalassemia patients also do not need to receive regular blood transfusions. They can still live a normal life like thalassemia minor patients.

3. Thalassemia major

Thalassemia major is related to how many genes have problems in the formation of alpha and beta chains in the blood. However, the striking difference between this type of thalassemia and the minor and intermedia types is that the symptoms of thalassemia tend to be more severe.

Alpha thalassemia major

In alpha thalassemia major, the number of problem genes is 3 in 4, or even all of them. With that many genes at fault, this condition can lead to fatal complications.

Thalassemia major types that occur in the alpha chain are also called hydrops fetalis or Hb Bart syndrome. According to the National Heart, Lung, and Blood Institute website, most babies born with this condition die before birth (stillborn) or shortly after birth.

Beta thalassemia major

Meanwhile, not much different from the alpha chain, beta thalassemia major type also occurs when all the genes forming the beta chain experience problems. This condition, also known as Cooley's anemia, can cause more severe symptoms of anemia.

People with severe thalassemia are usually diagnosed by a doctor at the age of 2. Patients may experience symptoms of severe anemia accompanied by the following symptoms:

• looks pale
• frequent infections
• decreased appetite
• jaundice (yellowish eye balls and skin)
• enlargement of organs

If you have seen some of the signs and symptoms of thalassemia major in your baby or child, tell your doctor right away. It is likely that the patient will be referred to a specialist in blood disorders (hematologist) and will be required to receive regular blood transfusions.

What are the possible complications of thalassemia?

Thalassemia is a disease that is quite difficult to cure. However, current thalassemia treatments can reduce the risk of complications and symptoms.

Here are some of the complications of thalassemia that may occur:

• Excess iron. People with thalassemia can get too much iron in their bodies, either from the disease itself or from blood transfusions. Too much iron can result in damage to your heart, liver and endocrine system, which includes the hormone-producing glands that regulate processes throughout your body.
• Infection. People with thalassemia have an increased risk of infection. This is especially true if you have had your spleen removed.

In cases of major or severe thalassemia, the following complications can occur:

• Bone deformity. Thalassemia can make your bone marrow expand, which causes your bones to widen. This can result in abnormal bone structure, especially in the face and skull. The dilated bone marrow also makes the bones thin and brittle, increasing the chance of fractures.
• Enlarged spleen (splenomegaly). The spleen helps the body fight infection and filter unwanted material, such as old or damaged blood cells. Thalassemia is often accompanied by the destruction of large numbers of red blood cells, making the spleen work harder than usual, causing the spleen to enlarge. Splenomegaly can make anemia worse, and can reduce the lifespan of transfused red blood cells. If the spleen grows too large, it may need to be removed.
• Growth rate slows down. Anemia can cause a child's growth to slow down. Puberty may also be delayed in children with thalassemia.
• Heart problems. Heart problems, such as congestive heart failure and abnormal heart rhythms (arrhythmias), may be associated with severe thalassemia.