Background: 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. Methods: This is a descriptive cross sectional study carried out in 100 diagnosed patients of beta- thalassemia major who had visited the OPD/IPD of Subharti Medical College & affiliated Hospitals, Meerut for routine blood transfusion or for any other complication. Patients were clinically examined and investigated for presence of one or more endocrine disorders on their routine appointments. Results: Endocrine disorders were detected in a total of 82 patients. Diabetes mellitus was detected in 12% patients, hypothyroidism in 36% patients and delayed puberty was found in 72% patients. Mean serum ferritin level was found to be 5831.0±2860.5 ng/ml in beta-thalassemia Major patients, while it was in normal range in control subjects. Conclusion: Research concluded with finding of Delayed puberty (72%), Hypothyroidism (36%) and diabetes mellitus as (12%) in beta thalassemia patients who were on regular blood transfusion therapy. Iron overload as serum ferritin level was found to be highly raised in all study case. On the basis of our study we recommend that early detection and management protocols for these endocrinopathies may improve the life prospects of beta-thalassemia Major patients. Keywords: Endocrine disorders, Hypothyroidism, Delayed puberty, Diabetes Mellitus Serum ferritin, Thalassemia Major.
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.
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