Late Cardiac Complications of Chronic, Severe, Refractory Anemia with Hemochromatosis.

A MONG patients wlho from infancy have had severe anemia, refractory to therapy and usually reqtiiring transfuisions, xve have observed the development of one or 1)0th of txxo cardiac complicationis uinuisuial for anicmia alone." One, acute pericarditis, appeared benign but often recutrred, xxhereas the seconid, congestive lheart failuire and arrhythmias, led to death xithin a few montlhs to a fecx years. These coomiplicationis coincided witlb signs of progressive massivxe overloacl of iron. WVe have observed the developruent of cardiac inivolvement an.d acquiiired hemochrmatosis in 41 patients, 39 xvith thalassemila major anid txxo xxith aregenerative aiteinia. Nineteen of the 41 patients had percarditis, 26 had congestive cardiac failuire, anid 10 patients suffered from both. Six of the 41 developed cardiac enlargement and an alnormal electrocardiogram; fou-ir of these died of sepsis before either pericarditis or congestive failulre xvas manifest. Only eight patients xho have passed the age of 8 years and have a sima-ilar anermia are thuis far freec fr-om. sigIIs of cardiac inivolvemenIt. There xvas