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Evaluation of Osteopathy in Thalassemia by Bone Mineral Densitometry and Biochemical Indices

The Indian Journal of Pediatrics volume 77, pages 987–991 (2010)Cite this article

Abstract

Objective

To evaluate osteopathy in thalassemia by bone mineral densitometry (BMD) and biochemical indices.

Methods

Prospective review analysis with no follow up from 2006 to 2007 of 42 regularly transfused thalassemics aged 10–25 years (27 boys, 15 girls) was done. Anthropometry, pubertal stage and symptomatology were noted. Urinary C–terminal cross–linked telopeptide of type–1 collagen (Crosslaps) by ELISA; serum 25–OH vitamin D and osteocalcin by RIA; parathyroid hormone (PTH) and ferritin by chemiluminescence and IGF–1 by Enzyme immunoassay were evaluated. Dual Energy X-ray Absorptiometry (DEXA) of lumbar spine and femur was done on Lunar prodigy system. Data was entered and analyzed using the SPSS for Windows software. Mean comparisons were done by ANOVA 1 and data was compared using Chi–square test and p value < 0.05 was taken as significant.

Results

Of 42 patients, 81% had osteoporosis by Z–score of DEXA. Urinary crosslaps was high in 55%; 36% had increased osteocalcin; 62% had low vitamin D levels; 38% had high parathyroid levels and IGF–1 was low in 52%. Mean serum ferritin level was 5344 ± 2855 ng/dl. There was statistical significance (p = 0.046) between chronological age and BMD. All 42 cases were divided into two groups: Group–1 (Normal DEXA), Group–2 (Abnormal DEXA) and analysis of biochemical indices between two groups showed no significant difference in any of the biochemical parameters.

Conclusion

This study revealed majority of thalassemics with inadequate chelation have bone resorption with advancing chronological age and BMD should be evaluated regularly for early diagnosis to prevent morbidity.

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Affiliations

  1. Department of Pediatrics, Dr Balabhai Nanavati hospital Mumbai, 501, Rangmahal 5th floor, 2 Mount mary road, Bandra (west), Mumbai, 400050, India

    Rashid Merchant & Amish Udani

  2. Department of RIA, P. D. Hinduja National Hospital and Medical Research Centre Mumbai, Mumbai, India

    Vipla Puri & Valentina D’cruz

  3. Department of Radiology, Dr. Balabhai Nanavati Hospital Mumbai, Mumbai, India

    Deepak Patkar & Aarti Karkera

Authors
  1. Rashid Merchant
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  2. Amish Udani
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  3. Vipla Puri
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  4. Valentina D’cruz
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  5. Deepak Patkar
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  6. Aarti Karkera
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Corresponding author

Correspondence to Rashid Merchant.

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Setting

Study at thalassemia day center of Dr. Balabhai Nanavati Hospital Mumbai, India.

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Merchant, R., Udani, A., Puri, V. et al. Evaluation of Osteopathy in Thalassemia by Bone Mineral Densitometry and Biochemical Indices. Indian J Pediatr 77, 987–991 (2010). https://doi.org/10.1007/s12098-010-0158-2

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  • DOI: https://doi.org/10.1007/s12098-010-0158-2

Keywords

  • DEXA
  • Osteoporosis
  • Thalassemia
  • Vitamin D