Hypocalcaemia due to hypoparathyroidism in ß-thalassemia major . A study of a new case
Keywords:
Hypocalcaemia, hypoparathyroidism, child, thalassemiaAbstract
Aim: To report a new case of hypoparathyroidism in a child with ßthalassemia major
Case: We report a case of a 17-year-old Tunisian girl with transfusion-dependent thalassemia major presented with paresthesia and pubertal delay. Laboratory investigations showed hypocalcaemia and hyperphosphatemia. Parathyroid hormone level was low (2 ng/l,
normal range: 12-72 ng/l) than expected for the degree of hypocalcaemia. Serum ferritin concentration was 1770ng/ml. The patient was started on oral daily calcium supplementation, Alfa calciferol and intensive iron chelation therapy. Follow-up after 6 and 12 months revealed normal Calcium and ECG showed QT interval
within normal range.
Conclusion: Investigating calcium homeostasis at regular intervals and early management of any abnormality can preclude the occurrence of complications
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References
Olivieri NF, Nathan DG, MacMillan JH, et al. Survival in medically treated patients with homozygous beta -thalassemia. N Engl J Med 1994; 331:574-78.
Najafipour F. Evaluation of Endocrine Disorders in Patients with Thalassemia Major. Int J Endocrinol Metab 2008; 2: 104- 13.
Chern JPS, Lin K-H, Lu M-Y, et al. Abnormal glucose tolerance in transfusion-dependent beta-thalassemic patients. Diab Care 2001; 24:850-4.
Ozment CP, Turi JL. Iron overload following red blood cell transfusion and its impact on disease severity. Biochim Biophys. Acta 2009; 1790:694-701.
Shamshirsaz AA, Bekheirnia MR, Kamgar M, et al. Metabolic and endocrinologic complications in beta-thalassemia major: A multicenter study in Tehran. BMC Endocrine Disorders 2003;3:23-34.
Gabriele O F. Hypoparathyroidism associated with thalassemia. South Med J 1971; 64:115-6.
Perignon F, Brauner R, Souberbielle JC, de-Montalembert M, Girot R. Growth and endocrine function in major thalassemia. Arch Fr Pediatr 1993; 50:657-63.
Multicenter study of prevalence of endocrine complications in thalassaemia major. Italian Working Group on Endocrine Complications in Non-Endocrine Diseases. Clin Endocrinol 1994; 42:581-6.
De Sanctis V, Vullo C, Bagni B, Chiccoli L. Hypoparathyroidism in beta thalassemia major. Clinical and laboratory observations in 24 patients. Acta Haematol 1992;88:105-8.
Zafeiriou DI, Athanasiou M, Katzos G, et al. Hypoparathyroidism and intracranial calcifications in ß-thalassemia major. J Pediatr 2001; 138:411.
Karimi M., Rasekhi A.R, M. Rasekh M.,et al. Hypoparathyroidism and intracerebral calcification in patients with beta-thalassemia major. Eur J Radiol 2009; 70:481-4.
Chern JP, Lin KH. Hypoparathyroidism in transfusion-dependent patients with beta-thalassemia. J Pediatr Hematol Oncol 2002; 24:291-3.
Chern JP, Lin KH, Tsai WY, et al .Hypogonadotropic hypogonadism and hematologic phenotype in patients with transfusion-dependent beta thalassemia. J Pediatr Hematol Oncol 2003; 25:880-84.
Cario H, Holl R, Debatin K, Kohne E. Insulin sensitivity and betacell secretion in thalassaemia major with secondary haemochromatosis: assessment by oral glucose tolerance test. Eur J Pediatr 2003; 162:139-46.
Angelopoulos NG, Goula A, Rombopoulos G, et al. Hypoparathyroidism in transfusion-dependent patients with bthalassaemia. J Bone Miner Metab 2006; 24: 87-93.
