الفهرس 
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Abstract
tudy of Neuro- Psychological Complications of Children with BetaThalassemia: Relation to Growth Pattern and Hematological Parameters
By
Nazif HK1, Moulokhia TK2, Deghidy A3, Azouz HG4
Institute of Post-Graduate Childhood Studies1, Ain- Shams University, Neurosychiatry
Department2, Clinical Pathology3 , Pediatrics4, Faculty of Medicine, Alexandria University
Introduction Children with thalassemia are vulnerable to neurological, emotional and
behavioral problems. Various authors have reported that up to 80% of children with thalassemia
are likely to have psychological problems. In thalassemic patients this is a risk factor for
noncompliance to treatment..
Aim of The work: The aim of the present study was to detect neuro-psychological
disturbances in beta-thalassemic children and to correlate between these disturbances and
hematological parameters, growth pattern and pubertal staging of these patients.
Subjects and Methods: This cross sectional study was conducted on forty children who are
suffering from beta-thalassemia. They have been all subjected to history taking, neurological
examination, anthropometric measurement, Laboratory investigations included: complete blood
count, Serum ferritin, Serum iron, Serum zinc, total iron binding capacity. Assessment of
electroencephalogram (EEG), Intelligent Quotient (IQ) , child behavior assessment using: Child
behavior Check List 6-18years (CBCL), Child Manifest Anxiety Scale (CMAS), and Child
Depression Invetory (CDI)
Results: The mean age in patients was 10.58 ± 2.7 years, 52% of studied patients had normal motor
system and 48% had abnormal motor system. 22.5% of patients had immature EEG background
activity and 5% had abnormal epileptiform activity. 50% of studied patients had subaverage IQ,
15 % of them had slow learnr. CBCL syndrome items T-score categories in the studied patients
showed that boys had a statistically significant higher withdrawn and somatic behavior than girls.
Somatic problems had highest percentage of clinical range was (47.5%). 14 (35%) of thalassemic
children had clinically abnormal high CBCL total. Abnormal CBCL Internalization problem
scores were seen in 55% of children. Clinically significant, abnormal CBCL Externalization
score was seen in 11(27.5%) of thalassemic children. 40% of the studied patients had high
anxiety grade. 17.5% of the studied patients had moderate depressive manifestations, and 25%
had no depressive manifestations. Abnormal motor system examination was related to
malnutrition, delayed puberty and high ferritin level. There was significant correlation between
hemoglobin with IQ. Immaturity of brain activity was related to lower weight and serum zinc
level. There was significant correlation between iron level and CBCL withdrawn depressed
complaints, social problems and rule breaking behavior. Attention problems were negatively
correlated with Weight z score and BMI z-score while aggressive behavior was negatively
correlated with BMIz-score. High CMAS score was related with lower weight, delayed puberty
and duration of chelation. High CDI score was related to delayed puberty.
Conclusion:. Thalassemia major exerts a dramatic influence on the mental health of affected
children.. Height and body mass index as well as serum iron and ferritin are correlated
significantly to these problems.
Keywords: Beta-thalassemia, neuro-psychiatric, ferritin , growth , iron , CBCL,EEG, IQ,