Vitamin D metabolism among Egyptian infants and children affected with beta thalassemia

ABSTRACT

Sixty-five patients suffering from beta-thalassemia major were studied [46 males and 19 females]. Their ages ranged between 6/12-12 years [mean 5.8 +/- 2.2 years]. Twenty-five children of comparable age, sex, and socioeconomic status were studied as controls. Patients were classified into newly diagnosed and long-standing, who were furtherly classified into cases without hyperspienism, cases with hypersplenism and splenectonized cases. Each patient was subjected to full history taking thorough clinical examination and determination of serum calcium, phosphorus, alkaline phosphatase both total and fractional isoenzymes [liver and bone], 25 [OH] vitamin D3 1, 25 [OH]2 vitamin D3 parathyroid hormone and urinary calcium excretion. Serum ca1cium was significantly decreased after splencctomy. Serum phosphorus was significantly decreased except in patients with hypersplenism who showed normal values. Parathyroid hormone was decreased after splenectomy. 25 [OH]2 VD3 showed high significant decrease except in patients with hypersplenism. 1, 25 [OH]2 VD, showed very high significant decrease in all patients. Calcium/creatinine ratio in urine showed a very high significant increase in all cases. It might be con eluded that follow up of the levels of serum Ca, P, 25 [OH] VD3 1, 25 [OH]2 VD3, and alkaline phosphatase should be carried out in all thalassemic patients for early supplementation with vitamin D to avoid any bone mineralization defect together with the regular follow up of parathyroid hormone level especially after splenectomy