ASSESSMENT OF SERUM CALCIUM, PHOSPHORUS AND VITAMIN D LEVELS IN MULTI-TRANSFUSED BETA THALASSEMIA MAJOR PATIENTS: A CROSS-SECTIONAL STUDY

Abstract

Background: Beta Thalassemia Major Patients Undergoing Frequent Blood Transfusions Are At Increased Risk Of Developing Endocrinopathies Due To Iron Overload. Despite Chelation Therapy, Complications Related To Calcium-Phosphorus Metabolism And Vitamin D Deficiency Persist. Limited Data Exists On These Parameters In The Indian Thalassemic Population.

Objective: To Evaluate Serum Levels Of Calcium, Phosphorus, And Vitamin D In Beta Thalassemia Major Patients Who Had Received 20 Or More Blood Transfusions And To Assess Their Correlation With Serum Ferritin Levels.

Methods: A Cross-Sectional Study Was Conducted At The Thalassemia Ward, Department Of Paediatrics, Government Medical College, Kota, From May 2022 To March 2023. Sixty Children Aged 5-18 Years With Beta Thalassemia Major Who Had Received ≥20 Blood Transfusions Were Enrolled. Serum Calcium, Phosphorus, Vitamin D, And Ferritin Levels Were Measured And Compared With Standard Reference Values. Results: Mean Serum Calcium Was 6.86±1.25 Mg/Dl (Standard: 8.4-10.2 Mg/Dl), Phosphorus Was 8.1±3.5 Mg/Dl (Standard: 2.3-4.7 Mg/Dl), And Vitamin D Was 19.37±8.98 Ng/Ml (Standard: >30 Ng/Ml). Hypocalcemia Was Present In 88% Of Patients. Vitamin D Deficiency (<20 Ng/Ml) Was Observed In 75% And Insufficiency (20-29 Ng/Ml) In 18.3% Of Patients. Serum Vitamin D (R=-0.8, P<0.01) And Calcium (R=-0.8, P<0.01) Showed Significant Negative Correlation With Serum Ferritin, While Phosphorus Showed Weak Positive Correlation (R=+0.2, P<0.01).  Conclusion: Multi-Transfused Beta Thalassemia Major Patients Demonstrate High Prevalence Of Hypocalcemia, Hyperphosphatemia, And Vitamin D Deficiency, Strongly Correlating With Iron Overload. Routine Monitoring And Appropriate Supplementation Are Recommended To Prevent Endocrine Complications And Improve Quality Of Life.