Praticò G, Di Gregorio F, Caltabiano L, Palano G M, Caruso-Nicoletti M
Clinica Pediatrica II, Università di Catania, Italia.
Pediatr Med Chir. 1998 Jul-Aug;20(4):265-8.
The AA. performed a screening test on 113 patients affected by beta thalassemia major ranging between 2 and 40 years of age, randomized among those who come to the Microcitemic Center of our Institute, and on a control group. In all of them serum levels of calcium, phosphate, parathyroid hormone (PTH), calcitonin and 25-OH vitamin D were measured. Average serum levels of PTH were significantly (P < 0.001) lower in our patients than in control group and 12.4% of the former were clearly under normal range, especially in the group over 16 years of age. Also serum levels of 25-OH vitamin D were lower in thalassemic patients than in controls, because of the presence of 32 patients with average values under normal limit. Our results are in agreement with current literature and underline the increasing incidence of endocrine complications in thalassemic patients who undergo high transfusion regimens, because of to the increase of hemosiderosis due to the low compliance to iron chelation therapy. Controversial is the pathogenesis of the absence of hypocalcemia in many patients with hypoparathyroidism and the cause of the deficit of vitamin D.
研究人员对113名年龄在2至40岁之间、在我院微细胞中心就诊的重型β地中海贫血患者以及一个对照组进行了筛查试验。对所有患者均检测了血清钙、磷、甲状旁腺激素（PTH）、降钙素和25-羟维生素D水平。患者组的平均血清PTH水平显著低于对照组（P < 0.001），且前者中有12.4%明显低于正常范围，尤其是16岁以上的患者组。由于有32例患者的平均值低于正常下限，地中海贫血患者的血清25-羟维生素D水平也低于对照组。我们的结果与当前文献一致，并强调了接受高输血方案的地中海贫血患者内分泌并发症发生率的增加，这是由于铁螯合治疗依从性低导致铁过载增加所致。许多甲状旁腺功能减退患者无低钙血症的发病机制以及维生素D缺乏的原因仍存在争议。
