Prevalence of skeletal changes in patients with b thalassemia major in mosul

Background: Thalassemia is a herieditary anemia resulting from defects in hemoglobin production. -Thalassemia which is caused by a decreas in the production of B-globin chains, affects multiple organs and is associated with considerable morbidity and mortality Aim: 1.To study the radiographic skeletal changes in transfusion dependent thalassemia patients attending thalassemic center in Ibn_Alather Children Teaching hospital in Mosul and to correlate these changes with age. 2.To asses growth retardation in those patients clinically by using normal growth charts comparing them with our records of weights and heights Setting: The study was conducted in Ibn Al-Atheer Children hospital, Thalassemia center. Mosul city,Iraq from August2009_Octobar 2010 as prospective study. Patients and Methods: Five hundred patients whose age ranged between( 6month _32 year) were studied. Two hundered patients were examind by x-ray for forearm, hand, skull X-ray. 300 patients take for them Chest X-ray. Results: The age of the studied sample ranged between 6 month _32 years. The peak incidence of the patients in the age group 6 month _10 years (29.4%), male to female ratio 1:1.2. Fifty three percent from urban areas and 47% from rural areas. Seventy seven percent of patients diagnosed during the first year of their lifes. Sixty five percent of patients non compliant on chelating agent (desferroxamin). ninty percent their hemoglobin before transfusion range between 7-9gm|dl, 31% had hand bone changes: thinning of bone cortex, fusi form shape metacarpal and phalangyal bone with osteoporosis and localized lucency. Twenty nine percent had abnormal long bone changes highest percentage in the age group 11-14 years, no any case of desferroxamin – induced bone dysplstic changes,71% of patients had osteoporosis of ribs, no any case of thoracic extramedullary hematopoiesis. Fourty two percent of patients their weights fall below 5th centil and 56% of their height fall below 5th centil Conclusion: Radiological skeletal changes in our patients is high in comparison to other thalassemic patients in other studies which is due to poor compliance of these patients to both blood transfusion and chelating agents.