A Case Study and a Brief Review on Dermatopathological Drug Reaction in Major Thalassemia

Thalassemia consists of a variety of genetic hemoglobinopathies. Thalassemia-major causes anemia in early age. Those suffering from thalassemia need frequent life-long blood transfusions to survive, resulting in iron overload in the body and many health problems. Much improvement has occurred in predicting the course of Thalassemia major thanks to iron chelation therapy. Edible iron chelating agents are the standard of the chelating process. Deferasirox is a newly developed orally active iron chelating tablet which is used on a daily basis. Th present case study investigated severe dermatopathological reactions to the Iranian made product of Deferasirox.

We present a case of adverse drug reactions in a thalassemic patient who was started on Deferasirox orally after receiving Deferoxamine injections for several years with no serious reactions. The patient experiences generalized maculopapular, deep red- blue partially purpuric itchy skin rashes throughout her body. The histopathological biopsy found superficial perivascular or dermatitis with low-grade vasculopathy, few eosinophils, and mild psoriasis form-supraglotticlichenoid epidermal reactions associated with Drug Reaction diagnosis.

With regard to inherent features, caution must be applied to start the original Deferasirox for the patients who will undergo the oral chelation process with a smooth increase in the daily dosage for a few weeks in order to create improved tolerance.