Prevalence of hypoparathyroidism, growth retardation in patients of Beta-thalassemia major

Abstract

Beta-Thalassemia is a genetic disorder which is associated with a lot of complications. Frequent blood transfusions result in increased iron deposition in various tissues leading to dysfunction of many vital organs. Endocrine disorders constitute a major part of such complications increasing the morbidity of thalassemia manifold in the affected patients. Early diagnosis of hypoparathyroidism (HPT) could prevent other severe disorders such as Tetany, seizures, osteopenia, and osteoporosis. Growth retardation can occur as complication of thalassemia as early as the 1st or 2nd year of life but these abnormalities more prominent after the 6 – 8 years of life.The aim of this study was carried out to determine; 1. The prevalence of Hypoparathyroidism (HPT) and Growth retardation in patients with beta thalassemia and to correlate them with serum ferritin, calcium, phosphorus and alkaline phosphatase levels; 2. The relationships of growth failure with certain variable including age, serum ferritin, mean hemoglobin level and gender of the patients. This is a descriptive cross sectional research study which was conducted on 200 subjects (100 cases and 100 controls) in the age group of 10-25 years who had visited the OPD/IPD of Subharti Medical College & affiliated Hospitals, Meerut. The cases included were with confirmed diagnosis of beta thalassemia major, with regular blood transfusions and serum ferritin levels >2000 ng/ml irrespective of chelation therapy. Out of 100 patients, Hypoparathyroidism was diagnosed in 18% patients, Growth retardation/ Short stature 93% and Weight loss was found in 93% patients. The mean age at diagnosis was 12.6 years (range 11-16 years), mean serum calcium was 7.53 mg/dl (range7.58-9.04 mg/dl), mean serum ferritin was 5831.0 ng/ml (range 2000-8,064 ng/dl) and mean serum phosphate was 5.63 mg/dl (range 4.50-7.73 mg/dl). Serum parathyroid hormone (PTH) levels were low in most of the patients. Short stature was observed in most of the patients, while it was found normal in control subjects.Significant Hypoparathyroidism (HPT) observed along with growth retardation in beta thalassemia patients (p < 0.001). 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 were found increased in cases as compared to control.