Abstract Ref Number = APCP932
Correlation between age and feritin with growth pattern in pediatric thalassemia major
Andi Cahyadi,Iin Fatimah,Maria Christina Shanty Larasati ,Mia Ratwita Andarsini,I Dewa Gede Ugrasena,Bambang Permono
Department of Child Health Faculty of Medicine Universitas Airlangga Dr Soetomo Hospital Surabaya Indonesia Department of Child Health, Faculty of Medicine, Universitas Airlangga Dr Soetomo General Hospital, Surabaya Department of Child Health, Faculty of Medicine, Universitas Airlangga Dr Soetomo Hospital Surabaya, Indonesia
Background : Pediatric thalassemia mayor usually developed with growth retardation, due to chronic-hypoxia, inadequate blood transfusion, iron overload, endocrinopathy and chelation. It was characterized by short-stature, shortening of upper body segment and shifting from normal growth pattern. Iron overload expressed by serum ferritin, will aggravate growth retardation. We would examine the unique correlation between feritin serum and growth pattern in pediatric thalassemia mayor.
Material : A cross-sectional study evaluated pediatric thalassemia mayor below 18 years at Soetomo Hospital Surabaya-Indonesia for growth pattern (age, gender, weight, height, body mass index (BMI), and upper/lower segment ratio) using standard procedure and growth cart by CDC/NCHS 2000 in Z-score. Serum feritin was evaluated using electrochemilluminescence immunoassay technique. Correlation between variables were analyzed using Spearman-rho (p=0.05).
Results : Of 29 children, 15/29 was male with median age 125 (31 to 212) months, 18/29 aged above 9 years old. The increasing age had negative correlation with height Z-score (r=-0.520; p=0.04), weigh Z-score (r=-0.543; p=0.003), upper/lower segment ratio (r=-0.583; p=0.001), and BMI Z-score (r=-0.455; p=0.013). Short stature occurred in 16/29 (55.2%), 13/16 aged above 9 years. About 21/29 children had increasing upper/lower segment ratio (16/21 aged >9 years old and 12/21 boys). Increasing ferritin level correlate with upper/lower segment ratio (r=-0.594; p=0.001), higher in deferasirox group than deferiprone (p=0.002; 4647 vs 2328 ng/dL).
Conclusions : Growth pattern in pediatric thalassemia major was unique. Increasing feritin and age would increase the risk of short-stature and decrease Z-score BMI, indicated slowing of height velocity more pronounce than decreasing of body weight. Increasing age would decrease upper/lower segment ratio, indicated that short stature caused by shortening of trunk segment (vertebral bone).
Keywords: pediatric thalassemia major feritin growth patern