Complications of Beta Thalassemia

The blood disorder beta thalassemia can bring complications that include things like bone damage, heart problems, and slow growth in children. Treatment can help you or your child avoid many of these problems.

Beta thalassemia lowers the amount of a protein in your body called hemoglobin. Hemoglobin helps red blood cells carry oxygen to your organs and tissues. If you or your child doesn't have enough hemoglobin, you can get anemia, which makes you tired and short of breath.

Low oxygen and too much iron cause most beta thalassemia complications. Iron is a mineral your body uses to carry oxygen and keep your muscles healthy. In beta thalassemia, your intestines absorb more iron than normal. The blood transfusions you get to treat the disease also contain iron. All of that extra iron builds up in your heart, liver, and the glands that make hormones and damages these organs.

The complications you or your child get depend in part on the type of beta thalassemia. "Beta thalassemia minor" is mild and usually doesn't cause problems. Anemia from "beta thalassemia intermedia" causes slowed growth in children, weak bones, and an enlarged spleen. "Beta thalassemia major" is the most serious type, and it can cause many complications, including slow growth in children, an enlarged spleen, heart and liver problems, and bone damage.

If you're the parent of a child who has complications from beta thalassemia, talk to your friends and family to get the emotional backing you may need as you help your child manage their symptoms. If you find yourself getting anxious or stressed out, talk to your doctor. They can put you in touch with social workers or mental health professionals who can help.

Slow Growth

Your child's body needs lots of energy to grow. Cells need oxygen to create that energy.

Without enough oxygen, a child will grow more slowly. Puberty may also start late in kids with beta thalassemia.

Enlarged Spleen

Your spleen is an organ that makes new infection-fighting white blood cells and filters out the old ones that your body doesn't need anymore. Beta thalassemia makes your spleen make more new blood cells and break down more old blood cells than usual, so it has to work harder.

Just like a muscle grows when you use it more, overuse makes your spleen get bigger. If your spleen gets too large, you may need an operation called a splenectomy to remove it.


Your spleen is part of your body's defense system against germs. It makes the white blood cells that protect you from infections.

An enlarged spleen doesn't work as well as it should, which could make you more likely to get sick. And if you have surgery to remove your spleen, you or your child will be more likely to catch infections like the flu and pneumonia.

Getting all of your recommended vaccines and taking antibiotics will help to protect you from some of these illnesses. Let your doctor know if your child with beta thalassemia runs a fever. This could be a sign of a serious infection.

Heart Problems

In severe beta thalassemia, both anemia and iron overload can damage the heart and cause problems like:

  • Fast heartbeat
  • Abnormal heartbeat called arrhythmia
  • Congestive heart failure, when the heart can't pump enough blood
  • Swelling of the membrane around the heart, called pericarditis
  • Enlarged heart
  • In rare cases, dilated cardiomyopathy, a disease of the heart muscle

Heart problems can get worse without causing any symptoms. You or your child should get tests like echocardiograms, a chest X-ray, and a stress test each year to watch for any problems. Medicine to remove extra iron in your body, called chelation therapy, can help prevent heart problems from too much iron.

Liver Problems

Your liver helps keep the right balance of iron in your body. Extra iron due to beta thalassemia or blood transfusions can build up and damage the liver.

Although it's rare, it is possible to get hepatitis B from a blood transfusion, which can also damage the liver.

Eventually your liver can become so scarred that it doesn't work right, a condition called cirrhosis.

Bone Damage

Your body makes new blood cells in bone marrow, the spongy area inside your bones. When you have anemia, your bone marrow has to work overtime to make enough red blood cells to meet your body's needs.

As the bone marrow works harder, it stretches. Your bones become thinner, wider, and weaker than usual. They can break easily.

Extra bone growth may also cause your forehead, cheekbones, or jaw to stick out more than usual.

Prevent and Treat Complications

Your doctor will monitor you or your child for complications and treat any problems. One way to avoid complications is to follow the treatment plan your doctor prescribed.

If you have severe beta thalassemia, blood transfusions can help you avoid some of these problems.

Chelation therapy helps prevent extra iron from damaging your organs. You get this treatment as a pill or shot. The medicine binds to iron in your body and removes it through your urine or a bowel movement.

Show Sources


CDC: "Thalassemia: Complications and Treatment."

Cooley's Anemia Foundation: "Cardiac Issues in Thalassemia," "Reminders About Infection and Thalassemia," "Thalassemia and the Spleen."

Indian Journal of Endocrinology and Metabolism: "Anemia and growth."

Johns Hopkins Medicine: "Beta Thalassemia."

Mayo Clinic: "Enlarged Spleen (splenomegaly)," "Thalassemia."

National Institutes of Health, Office of Dietary Supplements: "Iron."

National Organization for Rare Disorders: "Beta Thalassemia."

UCSF Benioff Children's Hospital: "Standard-of-Care Clinical Practice Guidelines (2012)."

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