A Study upon the Prevalence of Hypoparathyroidism among Patients Aged Above 10 Years Old with Majort Thalassemia Referring to Shafa Centre

Major Thalassemia is a chronic haemolytic anemia. It is the most common hemoglobinopathy disorder in Khuzestan province. Hypoparathyroidism is one of its endocrinologic complication due to iron deposition especially in second decade of life. Early diagnosis of this complication can prevent other severe disorders such as seizure, osteopenia, osteoporsis. The aim of this study was to study the prevalence of hypoparathyroidism among this group of patients. In this cross-sectional study, 96 patients with major Thalassemia aged above 10 years old referring to Shafa Thalassemia centre.The following information were collected: age, sex weight, duration and route of desferral injection, duration of transfusion therapy, vit-D and calcium consumption, social and educational level of parents, history of splenectomy, any history of seizure, tingling, chvostek, trousseau, carpopedal sings, plasma level of calcium, phosphorus, ALK.P, PTH, Bun, Cr, Ferritin, and total protein. The age of the patients ranged from 11 to 39 (mean 19.3 years). The prevalence of hypoparathyroidism was 27.1% (26 out of 96). All these inflected patients had low serum calcium, low PTH, high serum phosphours and low to normal ALK P. Tingling, chvostek sings, trousseau, and carpopedal spasm were observed in 46, 38.4, 30.7, and 11.5 % of the patients respectively. Sixty nine % of these only had one clinical sing, while 30.8 % had none. No significant correlation between social and educational level of parents with hypoparathyroidism (p= 0.74). In 58% patients level of serum ferritin was above 4000 ng/ml The average level of serum ferritin in thalassemia patient without hypo-parathyroidism was 2770 ng /ml while in10 patients thalassemic patients with hypoparathyroidism this level was 5020 ng/ml. Seven patients with irregular desferral administration had overt hypoparathyroidism. A significant correlation was observed between irregular desferral consumption with high ferritin level and hypoparathyroidism (p<0.01). The finding of this study suggest that, irrespective of their clinical sings, at 6 monthly or yearly intervals, the plasma level of PTH, Ca and ALK P of all patients with major thelassemia aged above 15 should be tested