In thalassaemia intermedia (non-transfusion-dependent thalassaemia, NTDT), a major complication unique to this group compared to transfusion-dependent thalassaemia major is:

• A Transfusion-related iron overload with cardiac haemosiderosis
• B Bone marrow suppression from frequent transfusions
• C Extramedullary haematopoiesis causing paravertebral masses and spinal cord compression ✓
• D Graft-versus-host disease from allogeneic marrow transplantation

Explanation

Extramedullary haematopoiesis (EMH) occurs in NTDT/thalassaemia intermedia where ineffective intramedullary erythropoiesis drives expansion of haematopoietic tissue beyond the bone marrow — producing paravertebral masses in thorax and abdomen, potentially causing spinal cord compression. Unlike transfusion-dependent thalassaemia major, transfusion-related iron overload is not the dominant complication. NTDT patients absorb excess dietary iron (elevated EPO suppresses hepcidin), developing iron overload from GI absorption rather than transfusions. Paravertebral EMH is a pathognomonic NTDT complication.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.