ICCBH2019 Poster Presentations (1) (226 abstracts)
Increased prevalence of fractures in poorly chelated children with beta thalassemia
Sonal Palande 1 , Veena Ekbote 1 , Raja Padidela 2 , Zulf Mughal 2 , Anuradha Khadilkar 1 , Vaman Khadilkar 1 , Eleni Kariki 3 & Nicola Crabtree 4
1Hirabai Cowasji Jehangir Medical Research Institute, Pune, India; 2Department of Paediatric Endocrinology, Royal Manchester Children’s Hospital Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK; 3Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Oxford Road, Manchester, UK; 4Department of Diabetes and Endocrinology, Birmingham Women’s and Children’s NHS Foundation Trust, Steelhouse Lane, Birmingham, UK.
Objectives: Patients with beta Thalassemia have been reported to have low bone mass; poorly chelated patients are likely to be at an even higher risk. Pubertal delay, hypogonadism, and reduced physical activity and sunlight exposure are likely to be additional contributors to poor bone health and increased fracture risk. The objective of our study was to assess the prevalence of fractures in Indian underprivileged, poorly chelated thalassaemic children.
Methods: We studied 167 children (3 to 18 years old, 72 girls) from June 2016 to March 2018. We assessed anthropometric variables, hemoglobin and serum ferritin concentrations. The children’s fracture history was recorded. We performed posteroanterior spine imaging using GE iDXA (Wisconsin, MD, USA) and carried out vertebral fracture assessment using the adapted Genant et al. semiquantitative method (Genant et al. 2009).
Results: Mean age was 11.6±3.9 years. The mean height, weight, and BMI for age Z-scores were −1.9±1.2, −1.6±0.9 and −0.8±0.9, respectively. The mean Hb and serum ferritin concentrations were 8.1±1.7 g/dl and 2151.3±1894.9 ng/ml respectively. In all, 25% of children had a history of low trauma fractures. Thirty-eight of the 167 children (23%) had a history of long bone fractures (LBFs); 7 children had 2 LBFs and 1 child had 3 LBFs. Three of these 38 children had vertebral fractures (VFs) in addition to LBFs; 2 children each had 1 VF, and 1 child had 2 VFs. Three of the 167 children (2%) had VFs without LBFs; 2 children had 3VFs and 1 child had 2 VFs.
Conclusion: The prevalence of fractures was high (25%) in thalassaemic children with poor chelation therapy in comparison to a prevalence of 9% reported in school going (2 to 18-year-old) Indian children (Khadilkar et al. 2015).
Disclosure: The authors declared no competing interests.
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