Assessment of serum zinc and copper levels in Egyptian children with β-thalassemia major

Abstract

Background Thalassemia, with about 60,000 individuals born annually, is a severe inherited anemia, arising from the failure of hemoglobin synthesis. Objective This cross-sectional study aimed at evaluating the levels of serum zinc and copper in Egyptian children with β-thalassemia major on two different oral iron chelators, and its relation to clinical and routine laboratory parameters. Materials and Methods This cross-sectional study was conducted on sixty Egyptian children, with β-thalassemia major, who were recruited from the Hematology Clinic in New Children Hospital. All of them were below 18 years old. The hemoglobin electrophoresis of each patient was revised as a diagnostic investigation. The patients were classified into two groups: Group I included 30 patients on oral deferasirox, while group II included 30 patients on oral deferiprone. Thirty, age-and-sex-matched children were included in the study as controls. Both cases and controls were subjected to laboratory investigations, which are complete blood count, bilirubin (total and direct), alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, calcium and phosphorous, and zinc and copper levels in serum. Samples were analyzed spectrophotometrically on Beckman AU 680 (Beckman Coulter International, Nyon, Switzerland) using dedicated manufacturer reagents. Serum zinc and copper levels were measured by atomic absorption spectrometry (Perkin Elmer, Buckinghamshire, United Kingdom). Results Thirteen percent of the studied cases had low serum zinc level, while none of the control children had low serum zinc level. There was only one case that had high serum zinc level. Thirty five percent of the studied cases had high serum copper level, while none of the controls had high serum copper level, and only one case had low serum copper level. Comparing both types of oral chelators, there was no significant difference in them, regarding the zinc and copper levels. Conclusions Serum levels of zinc and copper were significantly altered in the thalassemic cases more than the controls. These levels were not related to the type of oral chelator used or their serum ferritin levels.