Rheumatological complications of beta-thalassaemia: an overview

Rheumatology (Oxford). 2018 Jan 1;57(1):19-27. doi: 10.1093/rheumatology/kex058.


Beta-thalassaemia, an autosomal recessive haemoglobinopathy, ranks among the most frequent monogenetic diseases globally. The severe form of the disease, beta-thalassaemia major, is accompanied by progressive involvement of multiple organ systems as a result of the disease pathophysiology as well as iron overload from blood transfusions on a regular basis. Some of the manifestations might also be caused by medications used to manage iron overload. The purpose of this review is to highlight the rheumatological complications of beta-thalassaemia, which include musculoskeletal manifestations, such as arthritis and arthropathies, joint effusions, osteoporosis, bone fractures and myalgias, in addition to CTDs, such as pseudoxanthoma elasticum. Rheumatologists are strongly encouraged to take part in a multidisciplinary approach to the management of this debilitating disease.

Keywords: arthralgia; arthritis; aseptic necrosis of femoral head; deferiprone-related arthropathy; fractures; iron overload; joint effusion; osteoporosis; pseudoxanthoma elasticum; thalassaemia.

Publication types

  • Review

MeSH terms

  • Arthritis / etiology
  • Blood Transfusion*
  • Connective Tissue Diseases / etiology
  • Deferiprone
  • Femur Head Necrosis / etiology
  • Fractures, Bone / etiology
  • Humans
  • Iron Chelating Agents / adverse effects
  • Iron Overload / drug therapy*
  • Iron Overload / etiology
  • Joint Diseases / chemically induced
  • Myalgia / etiology
  • Osteoporosis / etiology
  • Pseudoxanthoma Elasticum / etiology
  • Pyridones / adverse effects
  • Transfusion Reaction
  • beta-Thalassemia / complications
  • beta-Thalassemia / therapy*


  • Iron Chelating Agents
  • Pyridones
  • Deferiprone