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One of the common DNA damages is the chemical alteration of single bases by alkylation, oxidation, or deamination. The altered bases cause mispairing and strand breakage during replication. This type of damage causes minimal change to the DNA double helix structure and can be repaired by the base excision repair (BER) pathways. BER corrects damaged DNA sequences by removing the damaged base and restoring the original base sequence using the complementary strand as a template.
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Under-recognized Hypoparathyroidism in Thalassemia

Hataitip Tangngam1, Pat Mahachoklertwattana1, Preamrudee Poomthavorn1

  • 1Mahidol University Faculty of Medicine, Ramathibodi Hospital, Department of Pediatrics, Bangkok, Thailand

Journal of Clinical Research in Pediatric Endocrinology
|May 5, 2018
PubMed
Summary

Hypoparathyroidism is common in thalassemia patients, affecting 38%. Lower fibroblast growth factor-23 (FGF-23) levels were observed in hypoparathyroid thalassemia patients compared to those with normal parathyroid hormone (PTH) levels.

Keywords:
hypocalcemiahypoparathyroidismThalassemiairon overloadfibroblast growth factor-23

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Area of Science:

  • Endocrinology
  • Hematology
  • Metabolic Bone Disease

Background:

  • Hypoparathyroidism, characterized by low parathyroid hormone (PTH) levels, is rare in thalassemia patients.
  • Asymptomatic hypocalcemia without elevated PTH may be more prevalent but often goes unrecognized.

Purpose of the Study:

  • To investigate the prevalence of hypoparathyroidism in transfusion-dependent thalassemia patients.
  • To compare serum calcium, phosphate, PTH, 25-hydroxyvitamin D, and plasma FGF-23 levels between thalassemic patients and healthy controls.

Main Methods:

  • Sixty-six transfusion-dependent thalassemia patients and 28 healthy controls were enrolled.
  • Measurements included serum calcium, phosphate, creatinine, albumin, intact PTH, 25-OHD, plasma intact FGF-23, and urinary parameters.
  • Tubular reabsorption of phosphate was calculated.

Main Results:

  • Thalassemic patients exhibited significantly lower serum calcium levels compared to controls.
  • Hypoparathyroidism was diagnosed in 38% of thalassemia patients; no symptomatic cases were observed.
  • Lower plasma FGF-23 levels were found in thalassemic patients and were significantly lower in hypoparathyroid patients.

Conclusions:

  • Hypoparathyroidism is not uncommon in transfusion-dependent thalassemia patients, particularly with suboptimal iron chelation.
  • Plasma FGF-23 levels are lower in hypoparathyroid thalassemia patients compared to those with normal PTH levels.