الفهرس | Only 14 pages are availabe for public view |
Abstract Pathological fractures had been reported in homozygous thalassemic patients. These fractures had been attributed to osteoporosis. Previous studies have shown that iron overload results in disturbance of function of most endocrine glands including parathyroid gland. Disturbance of calcium metabolism was supposed to be either due to: - defective parathonnone hormone secretion. or - defective hydroxylation ofvitamin D in the liver. So this study was carried out to study the problem of bone disease in thalassemic patients The present study was conducted on 40 thalassemic children aged between 4 and 22 years and 20 age and sex watched normal children. -.. Additionally, history taking, thorough clinical examinations, and laboratory investigations was performed serum calcium,phosphorus, alkaline phosphatase, iron, ferritin, parathonnone hormone and osteocalcin. Furthermore, bone density was measured by dual energy x-ray absorptiometry on lumber spine. from the present study it was found that thalassemic patients had <- significantly lower serum calcium level and low bone density than the control group. Correlation study was done and revealed that serum ferritin which is considered as an indicator of severity of the condition was negatively correlated with calcium level. This finding was supposed to be the result of cellular damage of parathyroid gland resulting from hemosiderosis. ’-i In addition, the thalassemic patients with serum ferritin> 1000 ng/ml had lower bone density than the thalassemic patients with serum ferritin < 1000 ng/ml indicating that the higher the serum ferritin level the more liability .ee~3E_=_eE._e5E.ITill ~~~~~~~~} to osteoporosis. Regular chelation therapy was found to be partially protective ....._ to the thalassemic patients against the risk of hypoparatyroidism. This observation was concluded from the results of this study which shows that patients on regular desferal therapy shows higher bone density than those on irregular desferal therapy. |