Open AccessBone Status in Patients with Sickle Cell Disease:
Author(s) -
Bassem S. El Deek
Publication year - 2011
Publication title -
saudi journal of internal medicine
Language(s) - English
Resource type - Journals
eISSN - 1658-5763
pISSN - 1658-7367
DOI - 10.32790/sjim.1.2.6
Subject(s) - medicine , parathyroid hormone , osteopenia , vitamin d and neurology , vitamin d deficiency , outpatient clinic , secondary hyperparathyroidism , hyperparathyroidism , population , gastroenterology , avascular necrosis , endocrinology , physiology , surgery , osteoporosis , femoral head , calcium , bone mineral , environmental health
Objectives (background): Both sickle cell disease and vitamin D deficiency are common among Saudi population. The present work asses Parathyroid hormone/Vitamin D axis as well as bone dynamics in young Saudi adults with sickle cell disease.
Methods: A case-control study includes forty patients known to have sickle cell disease from the outpatient clinics of North Western Armed Forces Hospital, Tabuk were randomly selected for the study. Another 120 healthy individuals were involved as control. Cases and control were subjected to full history taking, clinical examination, and radiologic and laboratory investigations.
Results: Bone image revealed diffuse osteopenia in 16 (40%) of the cases, avascular necrosis of the femoral head in 6 (15%), code fish vertebral bodies in 6 (15%) and coarse trabecular pattern in 6 (15%). Laboratory investigations for patients revealed hypocalcemia in 18 (45%), secondary hyperparathyroidism in 24 (60%), non-detectable vitamin D in 30 (75%) and detectable but subnormal vitamin D in 10 (25%). The mean level for serum calcium in cases was significantly less than that for the control (p < 0.001). The mean level for serum intact parathyroid hormone was significantly higher in the patients than the control (p < 0.001). The mean serum level for the Serum 25-hydroxyvitamin was significantly lower in the studied cases than the control. For the serum bone, specific alkaline phosphatase the mean level was significantly higher in case than control (p < 0.001).
Conclusion: Vitamin D deficiency through a common finding it is more severe in patients with sickle cell disease with subsequent secondary hyperparathyroidism and frequent hypocalcemia.