Page 235 - Abstract Book KONIKA 18

Hemato-Oncology

P-HO-015
Effect of Blood Transfusions on Potassium Levels
in Children Beta Thalassemia Major

Indah Pramita Sari, Olga Rasiyanti Siregar, Rina Amalia C Saragih
Department of Child Health, Faculty of Medicine Universitas Sumatera Utara/Haji Adam Malik Hospital,
Medan, North Sumatera, Indonesia

Abstract
Background Lifelong blood transfusion is indicated in most beta thalassemia major patients due to ongoing
hemolytic process. Blood products contain some elements which have some side effects. Red blood cell
metabolism during storage can result in leakage of red blood cell membranes leading to increased potassium
level. Objective To analyze the effect of red blood cell transfusion on potassium changes in beta thalassemia
major patients. Methods A cross-sectional study was conducted at one day care service for Hematology
Oncology RSUP H Adam Malik Medan from September 2020 to January 2021. Forty four patients fulfilled
inclusion criteria. Beta thalassemia major patients who received the last blood transfusion at the time of one
day care service were examined for potassium electrolyte level before and after red blood cell transfusion.
Data were processed with SPSS 17.0. To analyze correlation between two variables,Spearman correlation
test is used. Results Red blood cell transfusion affected on potassium changes in beta thalassemia major
patients. The mean value of potassium level before transfusion was 3.80 mEq/l (SD 0.41) mEq/L and the
mean potassium level after transfusion was 5.6 mEq/L. There was a tendency of increased potassium levels
in 32 people (72.7%) after being given a red blood cell transfusion. However, blood storage time did not
have a significant correlation with changes in potassium levels (P=0.509, r= -0.102). Conclusion There was
an effect of red blood cell transfusion on potassium change in beta thalassemia major patients.
Keywords: blood transfusions; potassium levels; beta thalassemia major; children

P-HO-016
D-dimer Level in Children with Severe Hemophilia A and Mild-Moderate
COVID-19: Case Report

Dewi Ayu Rosariah, Novie A. Chozie, Fitri Primacakti
Department of Child Health Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital,
Jakarta, Indonesia

Abstract
Background Hypercoagulable state with increased of d-dimer is remarkable sign of COVID-19. This condition
may not be found in hemophilia due to its natural course characterized by defect in thrombin generation,
which will subsequently will reduce fibrin and thrombus formations. Objective To demonstrate clinical
manifestations and management of COVID-19 in hemophilia Case We report 2 cases of severe hemophilia
A with mild-moderate COVID-19. The first patient had the infection from a family cluster and experienced
fever, cough, and diarrhea. There was no sign of breakthrough bleeding. The second patient was a case of
traumatic hydro-pneumothorax who was found to have the infection during in-hospital contact screening. He
showed no specific symptoms related to COVID 19. Platelet count, PT/APTT, and neutrophil-lymphocyte
ratio were within normal ranges. In the 1st and 2nd patient, d-dimer levels were 1460 and 589.9 µg/dL,
while fibrinogen were 280 and 234.7 mg/dL, respectively. Both of them did not receive anticoagulant due
to the unremarkable values of these thrombosis markers. They received antiviral treatment and factor VIII
administration as prophylaxis to maintain Factor VIII level above 30%. They were free from COVID-19
infection at the 14th day after onset of positive nasopharyngeal swab. During follow up, there was no sign
of bleeding or thrombosis. Conclusion The expected range of D-dimer level in severe hemophilia A children
with mild and moderate COVID-19 is still unknown. Our two cases indicated that d-dimer and fibrinogen
level were similar with children without hemophilia, but more data are still needed.
Keywords: hemophilia; COVID-19; balance of bleeding and thrombosis, anticoagulant

KONIKA XVIII Abstract Book 187