Study of Bone Mineral Density in Transfusion Dependent Thalassemia, its correlation with Biochemical and Hematological parameters: A Cross-Sectional Study

  • Hegde D MD, DNB Pediatrics and Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital
  • Ghildiyal R MD, Pediatrics and Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital
  • Sharma S MD, Pediatrics and Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital
  • Zope S MD, Pediatrics and Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital
  • Manavi KM MD, DNB Pediatrics and Neonatology, Seth GS Medical College and KEM Hospital
  • Ramaswamy M MD, DNB Pediatrics and Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital
Keywords: transfusion dependent thalassemia, osteoporosis, osteopenia, DXA scan, bone mineral density

Abstract

Background: In thalassemic patients, bone disease is an important cause of morbidity. Patients with transfusion-dependent thalassemia (TDT) are susceptible to osteopenia and osteoporosis, the mechanism being multi-factorial. The present study was undertaken to study the prevalence of osteopenia and osteoporosis in TDT patients and describe its correlation with biochemical, hematological profile. Method: A total of 84 patients with TDT on regular PRC transfusion and iron chelation therapy aged between 5-18years were enrolled in the study. Bone mineral densities (BMD) was measured by DXA scan (DXA spine/whole body) and categorized into normal, osteopenia and osteoporosis based on WHO grading system. Results: Out of 84 subjects, 57.1% had low BMD with 38(45.2%) having osteopenia and 10(11.9%) of them having osteoporosis. The prevalence of osteoporosis was found to be more by DXA Spine than DXA whole body which was found to be statistically significant (P=0.043). A high prevalence of hypoparathyroidism, hypocalcemia, hypovitaminosis D and increased serum phosphorous levels were noted among TDT patients with low BMD. Iron overload in Myocardium by T2*MRI also showed statistically significant association with low BMD as determined by DXA Spine. Conclusion: Low bone mass is one of the most prevalent complications among TDT patients. Osteoporosis is a progressive disease with multifactorial etiology. Iron overload status by T2* Cardiac MRI may be used as an early indicator for predicting Osteoporosis along with T-scores from DXA spine for early diagnosis and interventions. Further longitudinal prospective studies are needed to better understand the etiopathogenesis of bone disease in these patients.

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Author Biographies

Ghildiyal R, MD, Pediatrics and Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital

Head of department of Pediatrics

Sharma S, MD, Pediatrics and Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital

Associate Professor

Zope S, MD, Pediatrics and Neonatology, Lokmanya Tilak Municipal Medical College and General Hospital

Associate Professor

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How to Cite
Hegde, D., Ghildiyal, R., Sharma, S., Zope, S., K M, M., & Ramaswamy, M. (2024). Study of Bone Mineral Density in Transfusion Dependent Thalassemia, its correlation with Biochemical and Hematological parameters: A Cross-Sectional Study. Pediatric Review: International Journal of Pediatric Research, 11(4). Retrieved from https://pediatrics.medresearch.in/index.php/ijpr/article/view/774
Issue
Vol 11 No 4 (2024): Oct-Dec
Section
Original Article

Copyright (c) 2024 Author (s). Published by Siddharth Health Research and Social Welfare Society

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