ABSTRACT
Thalassemia is a common genetic disease. Patients usually have some forms of renal tubular dysfunction, which might be expressed by an increase in urinary excretion of marker enzymes such as N- Acetyl-beta-D-Glucosaminidase [NAG]. Also, zinc deficiency may be associated with thalassemia to varying degrees. Zinc is an essential trace element necessary for growth and for regulation of normal physiological functions. The aim of the present work was to study urinary NAG, serum zinc, RBC's zinc and urinary zinc excretion in children with beta-thalassemia major, Also, to study the effect of Desferrioxamine [DFO] therapy on these parameters. The study was conducted on 40 beta-thalassemic children divided equally into two groups. Group [A] included 20 children with a mean age 8 + 3.48 years who received regular iron chelation with DFO and group [6] included 20 children with a mean age 7.1 2 4.36 years who did not receive DFO. Twenty normal healthy children matched by age and sex were included as controls [group C]. Number of blood transfusions received by each child has been approximately calculated. The mean value in-group A was 115.55 +/- 89.96, and in-group 6, it was 70.8 +/- 189.29. There was no statistically significant difference between the two groups [P=0.123]. The mean RBCs zinc in the present study was higher in patients groups [AandB] than in-group C with a statistically significant difference, while serum zinc levels were not significantly different among the three groups. Also, the mean urinary zinc excretion level was statistically significantly higher in-group A than in-group B and both groups had statistically higher significant values than the control group. Finally, the NAG levels showed a statistically significant difference between the patients groups [AandB] and the control group. The mean value was 3.23 +/- 1.98 U/L in group A and 3.02 +/- 1.59 U/L in-group 6, while it was 1.84 +/- 0.76 in the control group
Conclusion: thalassemic patients seem to be protected from zinc deficiency but there may be an impairment of zinc utilization at tissue level. Also, urinary NAG excretion can be considered as a reliable marker of tubular damage and its determination is recommended for early detection of renal problems