Post Splenectomy Protein C Levels in Beta Thalassaemia Major Patients

Abstract

Objectives: To compare protein C levels with splenectomy status in beta-TM patients.

Methodology: Cross-sectional comparative study conducted in the Department of Pathology, Al-Nafees Medical College & Hospital, Islamabad in collaboration with the Thalassemia center of Pakistan Institute of Medical Sciences, and Islamabad Diagnostic Center, Islamabad. After written informed consent, 60 diagnosed beta-thalassemia major patients were enrolled based upon inclusion and exclusion criteria, there were 30 splenectomized and 30 non-splenectomized patients. Protein C levels were measured by chromogenic assay. The mean values of protein C were compared between splenectomized and non-splenectomized beta-TM patients by student’s t-test. Pearson correlation test was done to find the correlation between protein C and serum Ferritin, ALT, and serum albumin. A p-Value < 0.05 was considered statistically significant.

Results:The mean protein C values in non-splenectomized and splenectomized patients were 62.11±9.65% and 41.64±6.37% respectively with a significant difference by independent samples t-test (p=0.000).There were 45% (n=27) male and 55% (n=33) female patients. The mean age for the selected patients was 12.95 ± 5.43 years. The mean protein C activity in all thalassemia patients was 51.87 % ± 13.12.  The mean protein C activity in non-splenectomized patients was 62.11 % ± 9.66. 

Conclusion: Splenectomy in thalassemia increases the risk of hypercoagulability and thromboembolic complications. Splenectomized beta-TM patients have decreased protein C activity as compared to non–splenectomized beta-TM patients, signifying decreased activity of anticoagulant mechanisms