title: Clinical Manifestations of β-Thalassemia Major in Two Different Altitudes; Bushehr and Shahrekord.
abstract: BACKGROUND
  Patients with β-thalassemia major (TM) develop iron overload through increased iron absorption and transfusional therapy and it's the most important complication of TM. Thalassemia is common in coastal regions and lands with low altitudes. The aim of this study is to determine the effect of high and low altitude on serum ferritin and treatment requirement in two groups of β-thalassemia major (TM) patients.
  
  
  METHODS
  Patients were divided into two groups, the first group (No: 50) living at sea level (in the port of Bushehr, Iran) and the second group (No: 40) living at the altitude of 2061 m (in the city of Shahrekord, Iran). All patient's clinical history, blood transfusion and laboratory tests including complete blood count and hemoglobin electrophoresis were reviewed.
  
  
  RESULTS
  There were no significant difference in ferritin levels, transfusion period and diabetes incidence of the two cities patients (P>0.05). Patient's cardiac function and liver condition were significantly better in patients of Bushehr (P<0.05). Patients under 20 years in Bushehr were less splenectomized in comparison with Shahrekord (P<0.05).
  
  
  CONCLUSIONS
  Our result showed that some of clinical manifestations of patients in low altitude such as cardiac and liver condition were better. But it did not affect ferritin level probably due to transfusion and chelating therapy. Totally patients of Bushehr had better conditions and had longer survivals.
authors.affiliation: Assistant Professor, Department of Hematology and Oncology, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Ravanbod
authors.affiliation: Associate Professor, Department of Biochemistry, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Movahed
authors.affiliation: Assistant Professor, Department of Epidemiology, Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Ostovar
authors.affiliation: Assistant Professor, Department of Hematology and Oncology, Shahrekord University of Medical Sciences, Shahrekord, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Hajigholami
authors.affiliation: Assistant Professor, Department of Laboratory Sciences, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Khamisipour
authors.affiliation: Department of Immunology, Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Shokrollah
authors.initials: S
authors.lastname: Farrokhi
authors.affiliation: Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Darabi
authors.affiliation: Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Yasaman
authors.initials: Y
authors.lastname: Khosravi
authors.affiliation: Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Mohammad Kazzem
authors.initials: MK
authors.lastname: Gheybi
keywords: Altitude; Cardiac function; Ferritin level; β-thalassemia major