สมาชิก น.ส. กานต์ธีรา ปัญจะเภรี รหัสนักศึกษา 580799 ลำดับที่ 21 น.ส. มินลดา เหมยา รหัสนักศึกษา 580826 ลำดับที่ 22 น.ส. กรกฎ อุดมอาภาพิมล รหัสนักศึกษา 581645 ลำดับที่ 23 นาย ชากรณ์ อรรคนิตร รหัสนักศึกษา 581646 ลำดับที่ 24 น.ส. มาฮีรัน ตือเงาะ รหัสนักศึกษา 581648 ลำดับที่ 25 น.ส. ศุภนิดา สุขประเสริฐ รหัสนักศึกษา 581650 ลำดับที่ 26 น.ส. รัตน์ติยากร เชื้อจันทึก รหัสนักศึกษา 581652 ลำดับที่ 27 นายปิติกร รุ่งบวรฤทัย รหัสนักศึกษา 581667 ลำดับที่ 28 นาย พีรพล ลำเจียก รหัสนักศึกษา 581705 ลำดับที่ 29 น.ส. ชวิศา ขำคม รหัสนักศึกษา 581710 ลำดับที่ 30

A rare case of thalassemia minor with leg ulcer Case study A rare case of thalassemia minor with leg ulcer

A 28 year old female patient came with a complaint of a leg ulcer over the left medial malleolus. which had been present intermittently since 9 months. There was no history of trauma, pedal edema, varicose veins, calf pain, or a history suggestive of collagen vascular disease.

From the data of this case has not been possibly with vascular system. Physical examination of the patient has pallor. There was a single shallow irregular shape ulcer with a granulating floor the surrounding skin showed minimal erythema and hyperpigmentation. There were no varicose veins. The dorsalis pedis and posterior tibial arterial pulsations were well felt. There was no splenomegaly. From the data of this case has not been possibly with vascular system.

What is thalassemia minor ?

A thalassemia passive, which are rarely symptoms appear A thalassemia passive, which are rarely symptoms appear. Or someone might be just a carrier of the disease. Which is due to be unusual gene from through the father or mother. Ex. β-thalassemia trait, which has a genotype β/β+ , β/β0 . The symptoms will depend on the patient's anemia by looking at the levels of Hb.

Diagnosis

Parameter Lab data Normal Hb 10 mg/dL** Male 13 mg/dL Female 12 mg/dL Reticulocyte count 0.5%** 2% Hb A2 4.5%** 2.5% (Less than 3.5%) Hb F 1.9% 0.5% Hb A 97.6% 97% Serum ferritin 55 µg/dL 70 - 200 µg/dL TIBC 545 µg/dL** 250 - 404 µg/dL Transferrin saturation 10.1%** 25 - 43% Blood smear Hypochromic, microcytic anemia with poikilocytes and Target cell. (Sickling was absent)

β/β0 β/β β0/β β/β β/β β0/β Phenotype คือ Normal : β-thalassemia trait 50% : 50%

β/β0 β/β0 β/β β/β0 β/β0 β0/β0 Phenotype คือ Normal : β-thalassemia trait : β-thalassemia 25% : 50% : 25%

β/β0 β0/β0 β/β0 β/β0 β0/β0 β0/β0 Phenotype คือ β-thalassemia trait : β-thalassemia 50% : 50%

Discussion

Reports of leg ulcer with thalassemia have been few, possibly because this cause was of identified. Very few case of leg ulcer due to thalassemia minor has been reported from India. The pathogenesis of leg ulcers are believe to occur due to relative hypoxia from chronic anemia in tissue. Secondary infection may also play a part.

Treatment Of Thalassemia Normally, not require to treatment but should be transfusion when the patient has acute hemolysis. Treatment by antibiotics The patient was admitted to the hospital and treated with systemic antibiotics for 14 days. The ulcer was treated with zinc acetate spray and aluminium hydroxide cream.

Type of Thalassemia minor β-thalassemia trait α-thalassemia trait δβ-thalassemia trait Hereditary Persistence of Fetal Hemoglobin (HPFH)

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