Arterial Thrombosis in Hb-E Beta Thalassemia: A Mystery Unrevealed

A young female diagnosed with Thalassemia Intermedia (TI) was referred for severe anemia, marked jaundice, epigastric pain, dyspnoea, fever and edema feet. She was on RBC transfusions and was following up at the thalassemia center. Her laboratory investigations were suggesting AIHA with ongoing hemolysis and complications due to iron overload. From the time of presentation and during her hospital stay, multiple investigations were carried out and complications were dealt with. Surprisingly renal arterial thrombosis was detected which was an unusual feature in intermedia patients. Although patients with TI are considered to be intermediate in severity, multiple complications in them can be fatal. One has to be vigilant in dealing with such cases and should try to understand the pathophysiology of complications. Managing such cases is a challenging task for hematologists. We present here, our case in view of arterial thrombosis as an unusual and unanswered feature in TI patients.