IRON OVERLOAD AND GROWTH OF THALASSEMIC PATIENTS IN MARWAR REGION

Growth disturbances are a major clinical feature of thalassemic patients. Regular blood transfusions and iron-chelation therapy greatly contribute to the quality and longevity of thalassemic patients. The main objective of present study was to compare the current growth of Thalassemia major patients, taking into accounts the iron overload, transfusion and iron chelation therapy, therefore we planned this study. The present study was conducted on 63 Thalassemic patients were enrolled in this study from June 2008 to October 2008. These subjects were categorised into two groups: 36 children (<10 years) and 27 adolescents (>10 years). Enrolled subjects were examined for various anthropometric parameters as height, weight and body mass index. Venous blood samples were obtained for estimating serum ferritin. Family history (carrier status of father, mother or siblings), age of diagnosis, age of first blood transfusion, frequency of blood transfusion and details of chelation therapy were recorded during the study Serum Ferritin level was very significantly elevated in the adolescents when compared to children because the number of transfusion increases as age advance. Percentile curves (NCHS growth curves) showed pronounced growth retardation in height and weight after 10 years of age in both sexes.  A very significant difference (t=3.43, p<0.01)was observed between the serum Ferritin value of total no. of thalassemic  children (1496.59 ±74.05 ng/ML) and the thalassemic adolescents (2397.97 ± 1199.57 ng/ML).  Determination of serum ferritin and routine growth monitoring at regular intervals is necessary to detect any disturbance in growth and to establish an appropriate protocol for investigation and treatment.