Association between age and serum ferritin level with bone age deficit in children with thalassemia major
Keywords:
growth, serum ferritin level, bone age, thalassemia major
Abstract
Background Multiple blood transfusions in thalassemia patientslead to iron overload in bone tissue. Iron overload can be
determined by serum ferritin measurement. Several studies have
evaluated association between serum ferritin level and growth,
but without bone age examination.
Objective To determine the association between age and serum
ferritin level with bone age in children with thalassemia major.
Methods This study was conducted at Hasan Sadikin Hospital
Bandung during March-May 2007. We performed physical
examination, serum feritin measurement, and bone age
examination. Data were analyzed with x 2 to determine association
between variables. The association between age and serum ferritin
level with bone age deficit was analyzed with regression logistic
model.
Results Subjects consisted of 49 patients with thalassemia major.
All subjects had bone age deficit. Most boys were in age group of
>10 years and had bone age difference >36 months, while most
girls were <10 years and had bone age difference <36 months.
Subjects with bone age difference <36 months mostly had serum
ferritin level <5,000 ng/dL, while most subjects with bone age
difference >36 months had serum ferritin level =5,000 ng/dL.
This was statistically significant (x 2 =4.573, P=0.032). There was
association between age and bone age deficit (OR=13.461, 95%
CI 3.199;56.640), but not with serum ferritin level (OR= 2.199,
95% CI 0.532;9.095).
Conclusion In thalassemic children, bone age deficit is associated
with age, but not with serum feritin level.
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16. Filosa A, Di Maio S, Baron I, Esposito G, Galati MG. Final
height and body disproportion in thalassemic boys and girls
with spontaneous or induced puberty. Acta Paed 2000;
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17. Pooya A, Karimi M, Roth C. Growth retardation in children
with thalassemia major. Haematology 2004;7:493-6.
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Melevendi C, et al. Growth and sexual maturation in
thalassemia major. J Pediatr 1985;106:150-5.
19. De Sanctis V, Katz M, Vullo C. Effect of different treatment
regimens on linear growth and final height in ß-thalassemia
major. Clin Endocrinol 1994;40:791-8.
20. De Sanctis V, Savarino L, Stea S, Cervelatti. Microstructural
analysis of severe bone lesions in seven thalassemic patients
treated with desferoxamine. Calcif Tissue Int, 1994;67:128-
1332.
21. Oliveri NF. The b-thalassemia. N Engl J Med 1999;341:99-
109.
22. Filosa A, Di Maio S, Lamba M, Baron I, Saviano A, Esposito
G. Bone age progression during five years of subtitutive
therapy for the induction of puberty in thalassemic girl-effect
on height and sitting height. J Pediatr Endocrinol Metab
1999;12:525-30.
oncology. 2 nd ed. New York: Churchill Livingstone Inc;
1995. p. 135-45.
2. Comprehensive Thalassemia Centers. Thalassemia. (cited 2006
May 26). Available from: url: http://www.thal.SOC.guide.htm.
3. Takeshita K. Thalassemia beta. (cited 2006 May 26).
Available from: url: http//www.emedicine.com.
4. Hamidah A, Rahmah R, Azmi T, Aziz J, Jamal R. Short
stature and truncal shortening in transfusion dependent
thalassemia patients: result from a thalassemia center in
Malaysia. Southeast Asian J Trop Med Public Health
2001;32:625-30.
5. Shamsirhaz AA, Bekheirnia MR, Kamgar M, Pourzahedgilani
N, Bouzari N Habibzadeh M. Metabolic and endocrinologic
complication in beta-thalassemia major: a multicenter study
in Tehran. BMC Endocrine Disorders 2003;3:1-6.
6. Olivieri NF, Brittenham GM. Iron-chelating therapy and
the treatment of thalassemia. J Am Society Hematol 1997;
89:739-54.
7. Bronspiegel WN, Oliveri NF, Tyler B, Andrews DF, Freedman
MH, Holland FJ. Effect of age at the start of iron chelation
therapy on gonadal function in ß-thalassemia major. N Engl
J Med 1990;323:713-9.
8. Shalitin S, Carmi D, Weintrob N, Philip M, Miskin H,
Kornreich L, et al. Serum feritin level as a predictor of
impaired growth and puberty in thalassemia major patients.
Eur J Haem 2005;74:93-100.
9. Garofalo F, Piga A, Lala R, Chiabotto S, Di Stefano M, Isaia
GC. Bone metabolism in thalassemia. Ann N Y Acad Sci
1998;850:475-8.
10. MCHB. Using the CDC growth charts accurately weighing
and measuring technique. 2003. (cited 2006 May 26).
Available from: url: http://www.depts.washington.edu/
growth/module5/ text/page4a.htm.
11. Piga A. Monitoring of iron chelation and iron overload.
(cited 2006 Mei 19). Available from: url: http://
www.europeangeneticsfoundation.org.
12. Pribadi D. Perbandingan kadar feritin serum antara penderita
thalassemia beta mayor yang berperawakan pendek dan yang
mempunyai tinggi badan normal [Thesis]. Bandung:
Universitas Padjadjaran; 2006.
13. Grimberg A, Leon DD. Disorders of growth. In: Moshang T,
editor. Pediatric endocrinology, the requisites in pediatrics.
1 st ed. St. Louis: Mosby Inc; 2005. p. 127-66.
14. Brook CG. Growth assessment purpose and interpretation.
In: Brook CG, Hindmarsh PC, editors. Clinical pediatric
endocrinology. 4 th ed. London: Blackwell Science Company;
2001. p. 115-23.
15. Kattamis C, Touliatius N, Haidas S. Growth of children with
thalassemia: effect of different transfusion regimens. Arch
Dis Child 1970;45:502-5.
16. Filosa A, Di Maio S, Baron I, Esposito G, Galati MG. Final
height and body disproportion in thalassemic boys and girls
with spontaneous or induced puberty. Acta Paed 2000;
89:1295–1301.
17. Pooya A, Karimi M, Roth C. Growth retardation in children
with thalassemia major. Haematology 2004;7:493-6.
18. Pignatti CB, De Stefano P, Zonta L, Vullo C, De Santics V,
Melevendi C, et al. Growth and sexual maturation in
thalassemia major. J Pediatr 1985;106:150-5.
19. De Sanctis V, Katz M, Vullo C. Effect of different treatment
regimens on linear growth and final height in ß-thalassemia
major. Clin Endocrinol 1994;40:791-8.
20. De Sanctis V, Savarino L, Stea S, Cervelatti. Microstructural
analysis of severe bone lesions in seven thalassemic patients
treated with desferoxamine. Calcif Tissue Int, 1994;67:128-
1332.
21. Oliveri NF. The b-thalassemia. N Engl J Med 1999;341:99-
109.
22. Filosa A, Di Maio S, Lamba M, Baron I, Saviano A, Esposito
G. Bone age progression during five years of subtitutive
therapy for the induction of puberty in thalassemic girl-effect
on height and sitting height. J Pediatr Endocrinol Metab
1999;12:525-30.
Published
2008-02-29
How to Cite
1.
Andayani S, Sekarwana N, Fadil R. Association between age and serum ferritin level with bone age deficit in children with thalassemia major. PI [Internet]. 29Feb.2008 [cited 22Nov.2024];48(1):33-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/463
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Received 2016-09-05
Accepted 2016-09-05
Published 2008-02-29
Accepted 2016-09-05
Published 2008-02-29
