Khalida Parveen Basha N1, Beena Shetty2, U V Shenoy3. 1. Consultant Biochemist and Section Head, Triesta Reference Laboratory, A Unit of Health Care Global Enterprises , Bangalore, India . 2. Professor, Department of Biochemistry, Kasturba Medical College , Manipal University, Mangalore, India . 3. Professor, Department of Paediatrics, Kasturba Medical College , Manipal University, Mangalore, India .
Abstract
INTRODUCTION: The aim of this study was to assess the parathyroid functions and bone mineral density (BMD) in patients with beta thalassemia and to correlate them with serum ferritin, calcium, phosphorus and alkaline phosphatase levels. MATERIALS AND METHODS: This is a case control study which was done on 55 subjects (40 cases and 15 controls) in the age group of 2-18 years. The cases included were with confirmed diagnosis of beta thalassemia major, more than ten blood transfusions and serum ferritin levels >2000 μg/L irrespective of chelation therapy. RESULTS: Significant Hypoparathyroidism (HPT) observed along with low BMD levels in beta thalassemia patients (p < 0.01). A significant decrease in serum calcium level was seen in cases when compared to controls, where as the levels of both serum phosphorus and alkaline phosphatase levels increased in cases when compared to controls. CONCLUSION: BMD and PTH levels are very useful tools for diagnosing HPT. As a routine, in beta thalassemia major, screening for vitamin D deficiency and hypocalcemia should be done in second decade of life and as a preventive measure they should be supplemented with calcium and vitamin D to prevent hypocalcemic tetany, to facilitate bone growth and to prevent fractures.
INTRODUCTION: The aim of this study was to assess the parathyroid functions and bone mineral density (BMD) in patients with beta thalassemia and to correlate them with serum ferritin, calcium, phosphorus and alkaline phosphatase levels. MATERIALS AND METHODS: This is a case control study which was done on 55 subjects (40 cases and 15 controls) in the age group of 2-18 years. The cases included were with confirmed diagnosis of beta thalassemia major, more than ten blood transfusions and serum ferritin levels >2000 μg/L irrespective of chelation therapy. RESULTS: Significant Hypoparathyroidism (HPT) observed along with low BMD levels in beta thalassemiapatients (p < 0.01). A significant decrease in serum calcium level was seen in cases when compared to controls, where as the levels of both serum phosphorus and alkaline phosphatase levels increased in cases when compared to controls. CONCLUSION: BMD and PTH levels are very useful tools for diagnosing HPT. As a routine, in beta thalassemia major, screening for vitamin Ddeficiency and hypocalcemia should be done in second decade of life and as a preventive measure they should be supplemented with calcium and vitamin D to prevent hypocalcemic tetany, to facilitate bone growth and to prevent fractures.
Entities:
Keywords:
Bone mineral density (BMD); Dual energy X-ray absorptiometry (DEXA); Parathyroid hormone (PTH)
Authors: Catherine M Gordon; Laura K Bachrach; Thomas O Carpenter; Nicola Crabtree; Ghada El-Hajj Fuleihan; Stepan Kutilek; Roman S Lorenc; Laura L Tosi; Katherine A Ward; Leanne M Ward; Heidi J Kalkwarf Journal: J Clin Densitom Date: 2008 Jan-Mar Impact factor: 2.617
Authors: N F Olivieri; D G Nathan; J H MacMillan; A S Wayne; P P Liu; A McGee; M Martin; G Koren; A R Cohen Journal: N Engl J Med Date: 1994-09-01 Impact factor: 91.245