Parathyroid hormone in pediatric patients with β-thalassemia major and its relation to bone mineral density; a case control study

Abstract

Background: Thalassemia syndromes are heterogeneous groups of inherited anemias. Its treatment depends on recurrent blood transfusion with a problem of iron overload, which leads to multiple endocrinopathies including hypoparathyroid. The aim of the study is to estimate the level of serum parathyroid hormone and its relation to bone mineral density in transfusion dependent beta-thalassemia major children.

Subjects and methods: We measured serum calcium, phosphorus and parathyroid hormone in a sample of pediatric patients with thalassemia, compared them with age and sex matched healthy control. Measurement of bone mineral density by dual-energy X-ray absorptiometry was done in 2 sites: lumbar spine (L2–L4) in the anteroposterior position and left femur neck using Lunar Densitometry in osteoporosis Unit Ain Shams University Hospital for thalassemia patients.

Results: Thalassemic patients had significantly higher alkaline phosphatase and lower bone mineral density.

Conclusion: Osteopenia in β-thalassemia major patients is multifactorial and is mainly predisposed by defective function of the parathyroid gland and excessive iron deposition.

Keywords: Parathyroid; Thalassemia; Bone mineral density; Calcium; Phosphorous; Alkaline