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Abstract

PHYSICAL GROWTH PATTERNS IN TRANSFUSION-DEPENDENT THALASSEMIC CHILDREN AT WASIT CITY

Dr. Safaa A. Faraj MD*, Dr. Ahmed I. Insaf MD and Dr. Haider Nadhim Abd. MD MRCPCH

ABSTRACT

Objectives: Aim of Study: The main aim of this study is to determine the effects of age, type of chelation therapy, ferritin level and hemoglobin level on the physical growth of transfusion dependent thalassemia children. Subjects and Methods: This is a Cross sectional analysis for patients with thalassemia, registered at the thalassemia and hereditary anemia unit at Al-kut Maternity and child hospital, Wassit- Iraq- 2017. Growth parameters included height, weight, sexual maturity ratings according to tanner staging. Scores for weight, height were calculated using World Health Organization reference data. Laboratory parameters collected from patients records included: periodic Serum ferritin levels and pretransfusion Hemoglobin levels over the previous 2 years were calculated, type of chelating therapy, sex, age, presnceof endocrine disease were evaluated from patients records. Statistical analysis was carried out using SPSS. Results: Out of 200 patients registered at the thalassemia and hereditary anemia center at Al-Kut since 2006, 50 patients with thalassemia major and thalassemia intermedia included in the study. Their age ranging between 6-20 years of age with a mean age of 10.86 years. More than 75% of patients with thalassemia whose Hb levels below 10 g/dl were stunted growth. Most of the patients were treated with Deferasirox (Exjade) iron chelator (94%). Weight were found low in (50%) of patients whereas the height were found low in (74%) of patients. Both The Weight were significantly low (71%) and the Height (79%) were significantly low among patients with more than 10 years old. Also the Puberty was delayed in (100%) among16 patients whose age ≥ 14years. We found that the majority of our patients with high serum ferritin (more than3000ng/ml) had underweight (77%) and short stature (92%) for their age. Endocrinopathies were found in (31%) of our patients aged less than 10 years old and increase to 42% with older children. Conclusion: Thalassemia patients are in very high risk for Growth retardation including underweight and short stature and endocrinopathy in our thalassemia patients in kut city. Low pretransfusionhemoglobin, high serum ferritin and increasing age are important risk facters. Recomendations: Social education and government health planning is urgently needed to reduce the number of new born baby with thalassemia through obligatory screening program for new marriages. Transfusion dependent Thalassemic patients should carefully monitored and supported to decrease their suffer and complications, further studies and larger samples are needed to document and evaluate this burden disease.

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