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Abstract
This work was carried out on 50 thalassemic patients and 10 healthy children as control, during the period from April 2005 to April 2006 at Outpatient Clinic of Hematology Unit of Pediatric Department of Zagazig University Hospitals. Criteria of the patient as already diagnosed as beta-thalassemia, 43 patients as thalassemia major and seven patients as thalassemia intermedia, with age more than 10 years up to 25 years. Both sexes were included. Ten healthy children cross-matched age and sex from Outpatient Clinic of General Pediatrics were selected as control. Patient group were classified according to blood glucose level into three groups: Group 1: Patients with normal glucose tolerance. Group 2: Patients with impaired glucose tolerance. Group 3: Patients with diabetes mellitus. All the patients and controls (both sexes) were subjected to: 1- Full history. 2- Complete clinical examination. 3- All the patients and controls (selected groups for laboratory comparison) were subjected to: (a) All routine investigations as complete blood picture, hemoglobin electrophoresis, serum ferritin, liver function and renal function and hepatitis markers for hepatitis C and B. (b) Fasting and postprandial blood glucose.
(c) Mean pre-transfusion hemoglobin. (d) Fasting C-peptide. (e) Hemoglobin A1c for diabetic patients. Our study revealed the following: There is significant decrease of all clinical parameters in thalassemic patients than that of controls. There is significant decrease in level of Hb in thalassemic patients than controls. There is significant increase in level of serum ferritin, SGOT, SGPT and bilirubin level in thalassemic patients than that of controls. There is significant decrease in level of C-peptide in thalassemic patients that of controls. There is significant increase in level of fasting and postprandial blood sugar in thalassemic patients than that of controls. Hepatitis markers of hepatitis C virus was detected in 86% of thalassemic patients. Hepatitis B virus was detected in 4% of thalassemic patients, there is significant positive relationship between hepatitis infection and level of blood glucose. There is significant positive relationship between level of serum ferritin and blood glucose level. There is significant positive relationship between level of serum ferritin and duration of chelation therapy. There is positive relationship between level of serum ferritin and splenectomy. Our results show significant reverse relationship between duration of iron chelation and level of blood glucose level in thalassemic patients.