ABSTRACT
Beta Thalassemia is a chronic hemolytic anemia in which treatment by regular transfusion of packed Red blood cells [RBC] is the mainstay of patient's care. The resulting iron overload is the major cause of morbidity for these patients. Deposition of iron in the liver, endocrine glands and in the heart results in hemochromatosis in these organs. Type 2 diabetes is a common complication of iron overload. The development of diabetes in hemochromatosis is related to the magnitude of excess iron. The aim of the present work was to study the prevalence of abnormal glucose tolerance in thalassemia patients and detect whether increased echogenicity of the pancreas is correlated to the magnitude of iron excess, and to study the relation between hemosiderosis and pancreatic dysfunction. For this work, we first examined forty four patients with thalassemia major attending the Hematology Unit of Damanhour Medical National institute [DMNI]. Later on the number of patients enrolled in the study extended to ninety. Laboratory assay included fasting serum glucose level [FSG], 2 hours post prandial serum glucose level [PPSG], serum ferritin [S-Fe] and abdominal ultrasound [U/S]. The study showed that hemochromatosis was associated with increased pancreatic echogenicity and abnormal glucose level. Serum ferritin concentration and hepatitis C infection are risk factors for abnormal glucose found in transfusion-dependent thalassemia patients. Early aggressive iron chelation therapy and prevention of infections are the most important issues in managing glucose intolerance in transfusion-dependent Beta thalassemia patients