Iron overload in severe b-thalassemia (b-thalassemia major) patients is primarily a consequence of:

a. An increased rate of absorption of iron because of the severe anemia
b. A decreased need for iron because fewer RBCs are made
c. Accumulation of iron from massive RBC transfusion therapy
d. Decreased rate of use of iron because smaller RBCs are made

ANS: C
Patients with b-thalassemia major have a severe anemia; many of their clinical problems are related to this anemia. Giving the patient massive red cell transfusion therapy can ameliorate some of these clinical problems. Unfortunately, a serious consequence of this is the build-up of iron in the body from all the transfused RBCs because the body has no mechanism for excreting iron.