RESUMEN
Thalassemia and the blood transfusion complications associated with it predispose children to poor bone health. This study was conducted to determine the prevalence of bone-related abnormalities within this population. Forty two transfusion-dependent beta thalassemic subjects 5-19 years old in Assiut, Egypt, participated in this cross-sectional study. Medical history by interview and review of medical records, physical examinations including anthropometric measures and puberty assessment, and bone densitometry using DEXA and height adjustment were performed. The incidence of underweight and short stature was 73.8% and 69%, respectively, which were indicators of malnutrition among thalassemic subjects in this study. Low bone density [BMD Z-scores < -2] was detected in the lumbar spine and femoral region in 54.7% and 95.2% of subjects, respectively. But after height adjustment they became 11.9% and 64.3%, respectively. Forty-seven percent of patients had a history of fractures and the cumulative risk for which increased almost with age. Seventy-eight percent of patients reported bone pain, whilst back/hip pain was present in 69% of thalassemic children and adolescents. Genu valgus deformity and scoliosis were seen in 40.5% and 11.9% of patients. High incidence of low bone density and deficit in other aspects of bone health among thalassemia patients makes routine bone health assessment necessary for this vulnerable group. Considering influencing factors, dietary counseling and preventive supplementation therapy for this high risk group of children and adolescents may be necessary, although this should be assessed by intervention studies