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Mediterranean anemia: what it is, symptoms, diagnosis and possible treatment

It is called Mediterranean anemia , or beta-thalassemia in medical jargon , and as the name suggests it is a disease that is not particularly rare in Italy, especially in the southern regions where the incidence is higher. As the official portal of the San Donato hospital group also explains , this pathology is substantially hereditary, and takes the form of a malfunction of the red blood cells that may require a particularly controlled diet – or real periodic blood transfusions for the most serious cases.

A disease with ancient origins

The reason why this disease is particularly widespread in the countries of the Mediterranean area is to be found in antiquity. The form of anemia in question – in its milder forms – could in fact guarantee a certain degree of immunity against a very widespread disease, and much more dangerous for human survival: malaria. The abnormality of red blood cells due to thalassemia, caused by a reduced or absent synthesis of the beta chains of hemoglobin that lead to smaller than normal red blood cells, protects the blood from the spread of the malaria virus. Hence, the reason why Mediterranean anemia has perpetuated itself particularly in the southern regions of Italy, in the past particularly affected by the scourge of malaria due to the presence of numerous marshy soils (and therefore of mosquitoes capable of infecting with the virus). To date, it is estimated that in Italy there are about 7,000 thalassemia patients, with a particular concentration in Sicily (about 2,500) and Sardinia (1,500).

Symptoms and forms of the disease

There are three main forms of Mediterranean anemia that are described by medicine: thalassemia major,the most serious, thalassemia intermedia and thalassemia minor, which can sometimes even remain latent. All people who suffer from Mediterranean anemia, it should be specified, are susceptible to health complications at various levels, which can lead, especially in the most complex cases, to gallstones and problems with the spleen – which can be enlarged, and is sometimes surgically removed. Those who suffer from beta-thalassemia major can risk suffering from poor growth and skeletal abnormalities from the first years of life, with possible heart problems that can even lead to premature death. Other possible repercussions of the disease can occur on the health of the liver and endocrine glands. In addition to a series of cardio-circulatory difficultieswhich include heart dysfunction, arrhythmias, pericarditis and hypertension. Milder symptoms, on the other hand, include paleness and chronic fatigue. Being a hereditary disease , and not an infectious one, those suffering from Mediterranean anemia can genetically transmit it to their children, even if it is a healthy carrier.

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Diagnosis and possible treatments

The most common form of Mediterranean anemia to date is the one that occurs asymptomatically, and therefore falls into the category of thalassemia minor. This does not lead to particular problems in the patient’s everyday life, and is diagnosed through common laboratory tests. The blood tests, so to speak. No specific therapy is needed, in this case, unless pallor and weakness begin to become frequent problems: in this case the doctor can prescribe specific anti-anemic treatments based on folic acid and vitamin B12, or a diet always rich in folic acid , rich in green leafy vegetables, legumes or oranges. In the intermediate form, on the other hand, the need for occasional transfusions of red blood cells could be found; the major form, finally, requires much more drastic and constant treatments, ranging from frequent blood transfusions to marrow transplants.

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