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Year : 2018  |  Volume : 43  |  Issue : 2  |  Page : 63-68

Hypoparathyroidism in children with β-thalassemia major and its relation to iron chelation therapy

Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Fatma S.E Ebeid
2 Lotfy Elsayed St. Ain Shams University Staff’s Campus
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejh.ejh_42_17

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Background β-Thalassemia major (BTM) constitutes a major public health problem in Egypt. Early diagnosis of hypoparathyroidism (HPT) could prevent other severe disorders such as seizures, osteopenia, and osteoporosis. Objective The aim of this study was to determine the prevalence of HPT in patients with BTM and its relation to iron chelation therapy. Patients and methods This is a cross-sectional study that included 60 patients with transfusion-dependent BTM who were regularly attending the Pediatrics Hematology Clinic, Ain Shams University. The male–female ratio was 1 : 1.2. Their mean age was 12.47±3.63 years. The recruited patients were subjected to thorough clinical assessment with special emphasis on demographic characteristics, chelation and transfusion therapy, calcium consumption, age of onset of HPT, any symptoms of hypocalcemia, and presence of other complications. Laboratory investigations included hemoglobin electrophoresis, serum ferritin, serum calcium, serum phosphate, and serum parathyroid hormone levels. Results A total of 26 patients were on single iron chelation therapy, whereas 34 patients were on combination therapy. The prevalence of HPT was relatively high, as 20% were diagnosed as having HPT. There was a high prevalence of asymptomatic hypocalcemia (51.6%), including 12 patients who had HPT and 19 patients who had hypocalcemia without HPT. Moreover, 14 patients had hyperphosphatemia without HPT. Although HPT was less common in those treated with single-agent desferrioxamine, asymptomatic hypocalcemia was more prevalent in those who were treated with desferrioxamine iron chelation. In contract, hyperphosphatemia was more common in those on combination therapy. Conclusion HPT is not an uncommon complication of BTM, as well as the asymptomatic hypocalcemia, which necessitates early diagnosis and management.

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