Prevalence of hypoparathyroidism among patients with thalassemias: a systematic review and meta-analysis

Sezaneh Haghpanah; Zahra  Ghahramani; Mehran Karimi; Seyed Reza  Abdipour Mehrian; Erfan Taherifard; Shadi  Moshksar; Vincenzo De Sanctis; Sam Rahbin; Mani  Ramzi

doi:10.23750/abm.v96i1.16746

Authors

Sezaneh Haghpanah Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Zahra Ghahramani Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 2Hematology Oncology Clinic, American Hospital Dubai, Dubai, UAE
Mehran Karimi Hematology Oncology Clinic, American Hospital Dubai, Dubai, UAE
Seyed Reza Abdipour Mehrian Clinical Research Development Center, Amir Oncology Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
Erfan Taherifard Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran and MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran
Shadi Moshksar Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Vincenzo De Sanctis Pediatric and Adolescent Outpatient Clinic, Private Accredited Quisisana Hospital, Ferrara, Italy
Sam Rahbin Interdisciplinary Undergraduate Program in Neuroscience, Vanderbilt University, Nashville, Tennessee, USA
Mani Ramzi Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Keywords:

systematic review and meta-analysis

Abstract

Background: Thalassemia, the most prevalent hereditary anemic disease worldwide, significantly impacts public health, causing substantial morbidity and mortality. Clinically, β-thalassemia can be classified in transfusion-dependent thalassemia (TDT) and non–transfusion-dependent thalassemia (NTD). Hypoparathyroidism (HPT) is a common complication in TDT patients, with varying prevalence rates across different populations.

Objectives: This meta-analysis aimed to determine the prevalence of HPT among TDT and NTDT patients through a comprehensive review of studies.

Methods: A systematic review and meta-analysis of studies reporting HPT prevalence in thalassemia patients since 2000 was conducted. Data on prevalence rates, study characteristics, and patient demographics were extracted and meta-analyzed. Subgroup analyses were performed based on geographic regions.

Results: Overall, 3453 patients with thalassemias from 25 studies were included in this meta-analysis, of which 69 were NTDT patients. A pooled HPT prevalence of 11.3% (95% CI: 8.1-15.5%) was detected. The highest prevalence was observed in Europe at 19.1%, followed by Asia at 9.8%, and Africa at 6.2%. The mean age of participants was 19.0 (±1.1) years, with a nearly equal distribution of genders. No significant correlation was found between parathyroid hormone (PTH) levels and other biochemical parameters.

Conclusions: This meta-analysis shows a prevalence of 11.3% for HPT in thalassemia patients. Although, parathyroid dysfunction is primarily considered a disease of the second or third decade it could be seen in the earlier stage of life.Severity of disease, differences across populations, management of iron overload, adherence to iron chelation therapy, quality of healthcare systems, differences in diagnostics criteria and splenectomy may affect the distribution of HPT. These data should be dynamically updated as studies are published.(www.actabiomedica.it)

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