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Abstract
EVALUATION OF THALASSEMIC PATIENTS FOR HYPERURICEMIA, IRON STATUS AND THEIR IMPACT ON MUSCULOSKELETAL SYSTEM
Aseel Saad Tahir Maaroof*, Khalid N. M. Al-khero and Raghad Najm Abdullah Al Nuaimi
ABSTRACT
Background: Thalassemias, inherited hemoglobin synthesis defects, cause ineffective erythropoiesis, increased red blood cell destruction, reduced red blood cell life span, and chronic hemolytic anemia, with treatment involving blood transfusions leading to iron overload. Objectives: To assess serum uric acid and serum ferritin levels and their effect on the joints and their relation to the splenectomy and the gender in thalassemic patients. Patients and Methods: Case series study of 52 patients with beta thalassemia major (TM) from Thalassemia Center in Ibn-alatheer Teaching Hospital (34 males and 18 females) with age between 6 and 26 years. Venous blood samples were obtained from the patients and were analyzed for serum ferritin level, serum uric acid level and hemoglobin level. Any patient with articular or bone complain was sent for radiological assessment. Results: fifteen patients (28.9 %) with articular manifestation have only joint pain. The knee pain was in 13.5% of the patients, low back pain in 13.5 %, while the ankle affected only one patient (1.9%). In this study, it has been found that there is no significant relation between the serum ferritin and uric acid level with joint pain (p= 0.350 and 0.215 respectively). There is a significant effect of splenectomy on serum ferritin level p=0.042. Male patients showed a high serum ferritin level than female ones (p=0.033). The study also reveals that there is no significant relation between frequency of blood transfusion and the level of both serum uric acid and ferritin, yet significant relation exists with hemoglobin level p=0.029. Conclusion: Serum ferritin levels can be controlled with iron chelation agents, reducing iron overload impact on the musculoskeletal system. However, recurrent blood transfusions and improper chelating can lead to iron accumulation and secondary heamochromatosis. Most patients have normal uric acid levels.
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