Densidade mineral óssea em crianças talassêmicas: Uma experiência brasileira

Abstract

Osteoporosis is characterized by low bone mass and disruption of bone architecture, resulting in greater bone fragility with increased risk of fractures. Bone disease is an important cause of morbidity in beta thalassemia major patients. Osteoporosis has been described extensively in adult thalassemia. However, there are no studies describing Brazilian thalassemic children. We evaluated eleven patients with beta thalassemia major (median age of 10.0 years, range from 5 to 12 years) and twenty-four healthy children (median age of 9.5 years, range from 6 to 12 years), using dual X-ray absorptiometry to assess bone mineral density (BMD). Analysis of biochemical markers such as serum ferritin concentration, ionized calcium, alkaline phosphatase, phosphorus, albumin, prothrombin time and factor V was performed. The height was very different between the groups, p<0.05. The thalassemic patients showed significantly lower BMD (median 0.61 g/cm 2) than control subjects (median 0.69 g/cm 2) - p < 0.05. The relevant bone loss in the majority of thalassemic children studied emphasizes the need for identification and appropriate treatment of osteopenia, thereby reducing the morbidity of these patients. This is the first study described in the literature that determined bone mineral loss in Brazilian thalassemic children.