Skip to main content Skip to main navigation menu Skip to site footer

Correlation of serum ferritin with parathyroid hormone level in patients with transfusion-dependent thalassemia

  • Atika Purnama Sari ,
  • S. Ugroseno Yudho Bintoro ,
  • Ami Ashariati ,
  • Hermina Novida ,
  • M. Noor Diansyah ,
  • Putu Niken Ayu Amrita ,
  • Merlyna Savitri ,
  • Pradana Zaky Romadhon ,


Abstract

Introduction: Thalassemia is a rare hereditary condition that causes hemoglobin synthesis deficiency. Recurrent blood transfusion in transfusion-dependent thalassemia (TDT) individuals results in iron overload and deposition in body tissues, leading to endocrine malfunctions, including parathyroid. This study aimed to determine the correlation between the level of serum ferritin and parathyroid hormone level in TDT patients.

Methods: A cross-sectional study was conducted among adult TDT patients receiving blood transfusions at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia from January to June 2023. Serum ferritin was measured using an enzyme-linked fluorescence assay (ELFA), while parathyroid hormone was quantified using an enzyme-linked immunosorbent assay (ELISA). The Spearman correlation analysis was used to identify the correlation between the level of serum ferritin with parathyroid hormone.

Results: A total of 46 TDT patients were enrolled in the study, with a median age of 25 years old and represented predominantly by males (56.5%). The median levels of serum ferritin and parathyroid hormone were 5,672.90 ng/mL (min-max: 596.80–24,014.58 ng/mL) and 29.80 pg/mL (min-max: 10.61–97.01 pg/mL), respectively. The Spearman correlation analysis suggested a statistically insignificant negative correlation between serum ferritin and parathyroid hormone in TDT patients (r = -0.166; p=0.270).

Conclusion: Serum ferritin was inversely, but not significantly, correlated with parathyroid hormone in TDT patients, suggesting that impaired parathyroid function might be associated with the increment of plasma iron.

Keywords: Transfusion-dependent thalassemia serum ferritin level parathyroid hormone hemoglobin synthesis deficiency iron overload

References

  1. Setiati S, Alwi I, Sudoyo A, Simadibrata M, Setiyohadi B, Syam A. Textbook of Internal Medicine. Jakarta: Interna Publishing; 2014.
  2. Weatherall D. The thalassemias: the role of molecular genetics in an evolving global health problem. The American Journal of Human Genetics. 2004;74(3):385-92.
  3. Butar YB, Wardhani P. Thalassemia β Major in Confirmed Covid-19 Patient: A Case Report. Pharmacognosy Journal. 2022;14(4);1-9.
  4. Kattamis A, Forni GL, Aydinok Y, Viprakasit V. Changing patterns in the epidemiology of β‐thalassemia. European Journal of Haematology. 2020;105(6):692-703.
  5. Wahidiyat PA, Sari TT, Rahmartani LD, Setianingsih I, Iskandar SD, Pratanata AM, et al. An insight into Indonesian current thalassaemia care and challenges. ISBT Science Series. 2020;15(3):334-41.
  6. Pinto VM, Forni GL. Management of iron overload in beta-thalassemia patients: clinical practice update based on case series. International Journal of Molecular Sciences. 2020; 21(22):8771.
  7. Panigoro R, Rakhmila LE, Sribudiani Y, Maskoen AM, Tjandraprawira KD. Thalassemia in Indonesia: screening program, diagnosis and research. Hemoglobin. 2019;43(6):305-312.
  8. Nuryanti N, Ganie RA, Aman AK. β-Thalasemia Trait Menggunakan Elektroforesis Mikrokapiler. Indonesian Journal of Clinical Pathology and Medical Laboratory. 2015;21(2):174-8.
  9. Wahidiyat PA, Yo EC, Wildani MM, Triatmono VR, Yosia M. Cross-sectional study on knowledge, attitude and practice towards thalassaemia among Indonesian youth. BMJ Open. 2021;11(12):e054736. doi: 10.1136/bmjopen-2021-054736.
  10. Hernaningsih Y, Syafitri Y, Indrasari YN, Rahmawan PA, Andarsini MR, Lesmana I, et al. Analysis of Common Beta-Thalassemia (β-Thalassemia) Mutations in East Java, Indonesia. Frontiers in Pediatrics. 2022;10:925599.
  11. d’Arqom A, Indiastuti DN, Nasution Z, Melbiarta RR. pengembangan kader sekolah menengah untuk menurunkan insiden thalassemia di kabupaten bulak, surabaya development of high school cadres to reduce thalassemia incidence in bulak district, surabaya: A pilot project. Journal of Public Service. 2021;5(2):267-273.
  12. Cappellini M-D, Cohen A, Porter J, Taher A, Viprakasit V. Guidelines for the management of transfusion dependent thalassaemia (TDT). 2014.
  13. Vichinsky E, Levine L, Bhatia S, Bojanowski J, Coates T, Foote D, et al. Standards of care guidelines for thalassemia. Oakland: Children's Hospital and Research Center. 2012.
  14. Dasgupta S, Dasgupta A, Mukhopadhayay T, Bhattacharya S, Swaika B, Banarjee U, Chakrabarty P. Serum uric acid: an early indicator of oxidative stress in beta thalassemia population. Mymensingh Med J. 2013;22(3):567-73.
  15. Suryawan A, Ningtiar HW, Irwanto I, Ugrasena IDG. Determinant factors of depression in beta major thalassemia children. Folia Medica Indonesiana 2021; 57(1): 46-52.
  16. Ansari-Moghaddam A, Adineh HA, Zareban I, Mohammadi M, Maghsoodlu M. The survival rate of patients with beta-thalassemia major and intermedia and its trends in recent years in Iran. Epidemiol Health. 2018;40:e2018048. doi: 10.4178/epih.e2018048.
  17. Zamani R, Khazaei S, Rezaeian S. Survival analysis and its associated factors of Beta thalassemia major in hamadan province. Iranian Journal Of Medical Sciences. 2015;40(3): 233-239.
  18. Karimi M, Zarei T, Haghpanah S, Azarkeivan A, Kattamis C, Ladis V, et al. Evaluation of Endocrine Complications in Beta-Thalassemia Intermedia Patients: A Cross Sectional Multi-Center Study. Blood. 2018;132:2343-49.
  19. Toumba M, Sergis A, Kanaris C, Skordis N. Endocrine complications in patients with Thalassaemia Major. Pediatric Endocrinology Reviews. 2007;5(2):642-649.
  20. Pirinççioğlu AG, Gökalp D, Söker M. Parathyroid Functions in Thalassemia Major Patients. Annals of Clinical Endocrinology and Metabolism. 2017;1(1):015-9.
  21. Ashley E. Ferritin (serum, plasma). Association for Clinical Biochemistry. 2012:1-8.
  22. Minister of Health of the Republic of Indonesia. National Guide on Management and Treatment of Thallasemia. 2018.
  23. Well F. Haematinic investigations. The Science of laboratory Diagnosis. 2 ed. New Jersey: John Wiley & Sons Ltd; 2008.
  24. Panwar B, Gutiérrez OM. Disorders of iron metabolism and anemia in chronic kidney disease. Seminars in Nephrology; 2016: Elsevier; 2016. p. 252-61.
  25. Urmi S, Munira FT, Begum S. Relationship between serum ferritin and parathyroid function in adult male patients with transfusion dependent thalassemia. Journal of Bangladesh Society of Physiologist. 2022;17(1):1-5.
  26. Brissot P, Cappellini MD. Liver disease. Guidelines for the Management of Transfusion Dependent Thalassaemia (TDT) 3rd edition: Thalassaemia International Federation; 2014.
  27. Brissot P. Optimizing the diagnosis and the treatment of iron overload diseases. Expert Review Of Gastroenterology & Hepatology. 2016;10(3):359-70.
  28. Porter J, Viprakasit V, Kattamis A. Iron overload and chelation. Guidelines for the Management of Transfusion Dependent Thalassaemia (TDT) 3rd edition: Thalassaemia International Federation; 2014.
  29. Barton JC, Barton JC, Adams PC. Clinical and laboratory associations with persistent hyperferritinemia in 373 black hemochromatosis and iron overload screening study participants. Annals of Hepatology. 2017;16(5):802-11.
  30. Kohgo Y, Ikuta K, Ohtake T, Torimoto Y, Kato J. Body iron metabolism and pathophysiology of iron overload. International Journal Of Hematology. 2008;88:7-15.
  31. Prabhu R, Prabhu V, Prabhu R. Iron overload in beta thalassemia: a review. J Biosci Tech. 2009;1(1):20-31.
  32. Saliba AN, Harb AR, Taher AT. Iron chelation therapy in transfusion-dependent thalassemia patients: current strategies and future directions. Journal of Blood Medicine. 2015:197-209.
  33. Rüfer A, Bapst C, Benz R, Bremerich J, Cantoni N, Infanti L, et al. Role of liver magnetic resonance imaging in hyperferritinaemia and the diagnosis of iron overload. Swiss medical weekly. 2017;147(4546):w14550-w.
  34. Knovich MA, Storey JA, Coffman LG, Torti SV, Torti FM. Ferritin for the clinician. Blood reviews. 2009;23(3):95-104.
  35. Bogdan AR, Miyazawa M, Hashimoto K, Tsuji Y. Regulators of iron homeostasis: new players in metabolism, cell death, and disease. Trends in Biochemical Sciences. 2016;41(3):274-86.
  36. Prabowo NA, Megantara MA, Apriningsih H. The role of N-acetylcysteine in decreasing neutrophil-lymphocyte ratio in COVID-19 patients: A double-blind, randomized controlled trial. Narra J. 2023;3(2):e121-e.
  37. Shetty B, Shenoy U. Prevalence of hypoparathyroidism (HPT) in beta thalassemia major. Journal of clinical and diagnostic research: JCDR. 2014;8(2):24.
  38. Qarani W, Husna F, Yulia W, Zulkarnain Z, Syahrizal D, Gani BA, et al. Antioxidant and antiaging activity of Cinnamomum burmannii and Michelia champaca extract and combinations. Narra J. 2023;3(2):e111-e.
  39. Hagag AA, El-Shanshory M, Abo El-Enein A. Parathyroid function in children with beta-thalassemia and correlation with iron load. Adv Pediatr Res. 2015;2(3):1-6.
  40. Kurtoglu AU, Kurtoglu E, Temizkan AK. Effect of iron overload on endocrinopathies in patients with beta-thalassaemia major and intermedia. Endokrynologia Polska. 2012;63(4): 260-3.
  41. Cankurtaran M, Yavuz B, Halil M, Ulger Z, Haznedaroğlu I, Arıoğul S. Increased ferritin levels could reflect ongoing aging-associated inflammation and may obscure underlying iron deficiency in the geriatric population. European Geriatric Medicine. 2012;3(5):277-80.
  42. Ariningrum D, Adhipireno P, Suromo LB. Hyperferritinemia and oxidative stress in the kidney of beta thalassemia major. Bali Med J. 2019;8(2):596-601.

How to Cite

Sari, A. P., Bintoro, S. U. Y. ., Ashariati, A. ., Novida, H., Diansyah, M. N. ., Amrita, P. N. A. ., Savitri, M., & Romadhon, P. Z. . (2023). Correlation of serum ferritin with parathyroid hormone level in patients with transfusion-dependent thalassemia. Bali Medical Journal, 12(3), 3051–3055. https://doi.org/10.15562/bmj.v12i3.4772
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
0

Total
0

Share

Search Panel

Atika Purnama Sari
Google Scholar
Pubmed
BMJ Journal

S. Ugroseno Yudho Bintoro
Google Scholar
Pubmed
BMJ Journal

Ami Ashariati
Google Scholar
Pubmed
BMJ Journal

Hermina Novida
Google Scholar
Pubmed
BMJ Journal

M. Noor Diansyah
Google Scholar
Pubmed
BMJ Journal

Putu Niken Ayu Amrita
Google Scholar
Pubmed
BMJ Journal

Merlyna Savitri
Google Scholar
Pubmed
BMJ Journal

Pradana Zaky Romadhon
Google Scholar
Pubmed
BMJ Journal