الفهرس 
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Abstract
this work we aimed To asses bone mineral density in children with hemophilia using
DEXA scan and its relation to serum Parathormone, 25Vit D and RANKL
level.
The present study was conducted on 39 male patients with
hemophilia who were recruited from hematology clinic, Menoufia
University hospital and Elhelal health insurance hospital and 20 age
matched control males were included. An informed consent was taken
from the guardians of the included patients and the protocol of the study
was approved by the ethical committee.
All participants included in this study were subjected to:
1. Complete history taking stressing on the following:
Age
Sex
Severity of hemophilia for the patients
Dietetic history
Age of first diagnosis of the disease for the patients
Affection of daily activity for the patients
History of fracture for the patients
Frequency of receiving treatment for the patients
2. Anthropometric measures.
3. Clinical examination include:
Complete joint examination
4. Investigation
Included:
Laboratory:
1. Complete blood count
2. Serum calcium, phosphorus, Alkaline phosphatase, Kidney and
liver functions
3. Virology screen of both hepatitis C and B viruses
4. Serum receptor activator of nuclear factor-KB ligand (RANKL) by
ELIZA kits.
5. Parathormone hormone by ELIZA kits.
6. Serum 25(OH) Vitamin D by ELIZA kits.
Imaging:
1. Joint Ultrasound.
2. Dual energy x-ray absortiomtry (DEXA scan) to assess BMD.
The study showed that
1. The mean value of serum PTH in hemophilic patients was
30.45+16.51.
2. The mean value of serum 25(oH) Vitamin D in hemophilic patients
was 13.60+2.66.
3. The mean value of serum RANKL in hemophilic patients was
111.70+20.36.
4. There was statistically significant increase of serum RANKL in
patients group than control group with p-value<0.0001, while there
was no statistically significant difference regarding the other
parameters.
5. There was statistically significant decrease of serum 25VIT D of
patients group and control group than normal serum level with pvalue
<0.0001.
6. There was no statistical difference regarding serum 25VIT D between
patients group and control group.
7. There was statistically significant decrease of DEXA scan measures
in patients group than control group with P-value 0.031.
8. There was no statistically significant difference between the abnormal
mineral density group and normal mineral density group regarding
demographic data, anthropometric measures, duration of the disease,
diet, type of treatment, frequency of ttt, daily activity affection, and
bone pains.
9. There was statistically significant increase of serum RANKL in
abnormal mineral density group than normal mineral density group
with P-value <0.0001.
10. There was no statistical significant difference between the abnormal
mineral density group and normal mineral density group regarding
CBC, serum kidney and liver functions, serum calcium, phosphorus,
Alkaline phosphatase, 25(OH)Vit D and serum PTH.
11. There was no statistically significant difference between the
abnormal mineral density group and normal mineral density group
regarding HCV affection while there were no cases affected by HBV.
12. There was statistical significant positive correlation between
Colorado score and age of patients.
13. There was no statistical significant correlation between Colorado
score and both anthropometric measures and laboratory results.
14. There was no statistical significant correlation between serum
parathormone hormone and all parameters (anthropometric measures,
CBC, serum kidney and liver functions, serum calcium, phosphorus,
alkaline phosphatase, 25(OH) Vit D, serum RANKL and age in
years).
15. There was statistical significant positive correlation between 25 VIT
D and both weight centiles and height centiles of patients.
16. There was no statistical significant correlation between serum
RANKL and all parameters (CBC, serum kidney and liver functions,
serum calcium, 25(OH)Vit D, phosphorus, alkaline phosphatase, age
in years)