Measurement of Bone Mineral Density in the Transfusion Dependent Thalassaemic Patients
Showrab Biswas, Md. Salahuddin Shah, Md. Abdul Aziz, Md Rafiquzzaman Khan, Masuda Begum, Fatima Begum, Surozit Kumar Sarkar, Saqi Md. Abdul Baqi
Background: Thalassaemia causes a lot of complications. Among them low bone mineral density represents a major cause of morbidity in patient with thalassaemia. The mechanism of low bone mineral density in thalassaemic patients is multifactorial. Transfusion related iron overload in endocrine organs leads to impaired growth hormone secretion, diabetes mellitus, hypothyroidism, hypoparathyroidism, lack of sex steroids and vitamin D may contribute to impairment in achieving an adequate bone mass. Iron chelation therapy (Desferrioxamine) and bony expansion due to increase erythropoiesis cause bone loss ultimately developed low bone mass.
Aim: To determine the frequency of low bone mineral density in transfusion dependent thalassaemic patients
Methodology: This was a cross sectional observational study, was conducted in the Department of Haematology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka and National Institution of Nuclear Medicine & Allied Sciences (NINMAS), Bangladesh Atomic Energy Commission (BAEC). A total of 72 (Age ≥06 years to ≤ 40 years) transfusion dependent thalassaemic patients were included in this study. Presence of bone diseases was detected by Bone mineral density (BMD).
Results: Seventy- two (72) patients with transfusion dependent thalassaemia, aged 6 to 39 years were enrolled. Mean age of patients was 20.9±7.2 years. Among them, fifty-seven (79.2%) patients were found normal bone mineral density and fifteen (20.8%) patients were found low bone mineral density in the left femoral neck.
Conclusion: Low bone mass was significantly associated with low BMI, total number of blood transfusion and serum ferritin level in transfusion dependent thalassaemia. This study explores a new era of thinking for early detection of low bone mass and early treatment in transfusion dependent thalassaemic patients to prevent bone loss & its sequel.
Correspondence: Dr. Showrab Biswas, Department of Haematology, Chittagong Medical College Hospital, Chittagong.
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