This 10 years old child is confirmed case of thalassemia & has been admitted for blood transfusion. 2 questions: What are the facial features you can note in this patient? When will he require to have iron chelation therapy?




Features; frontal bossing, prominent facial bones, dental malocclusion. Chelating therapy is usually started 1-2yr of transfusions when ferritin level is 1000-1500 ug/l. Deferoxamine 40-60mg/kg/day is infused over 8-12hrs during night for 5-6days a week

I agree with the treatment.

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Chipmunk facies : frontal bossing, malar hyperplasia, flattening of nasal bridge, dental malocclusion. Due to repeated blood transfusions when the serum ferritin levels reach 1000-1500iu/l iron chelation is required.

Frontal bossing, maxillary bone prominence, upper lip Eventration, malocclusion. Chelation is regularly indicated. After each blood transfusion. Now treated RBC are transfussed to maintain Hb 10gmper dl. No to whole blood transfusion.

I agree with Dr. Dr. Nitesh

Thank u sir

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Chipmunk facies

Classical thalassemic facies / chipmunk facies / rhodent facies . Due to hypertrophy erythroid hyperplasia of marrow . Malocclusion of teeth can lead to dental caries n periodontal disease . Frontal bossing maxillary hyperplasia .


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Maxillary overgrowth Maloclusion of teeth Frontal bossing

Typical thalassemia faces fronal bossing flating of nasal bridge maxillary prominences maloclusion of teeth test fertin level after multiple transfusion if increase to 1000 to 1500 mcg do iron chelation

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Hutchison teeth

Nasal ridge depressed

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