Publication: Unrecognized vertebral fractures in adolescents and young adults with thalassemia syndromes
Issued Date
2013-04-01
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ISSN
15363678
10774114
10774114
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2-s2.0-84876151086
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Pediatric Hematology/Oncology. Vol.35, No.3 (2013), 212-217
Suggested Citation
Pontipa Engkakul, Pat Mahachoklertwattana, Suphaneewan Jaovisidha, Ampaiwan Chuansumrit, Preamrudee Poomthavorn, Niyata Chitrapazt, Suporn Chuncharunee Unrecognized vertebral fractures in adolescents and young adults with thalassemia syndromes. Journal of Pediatric Hematology/Oncology. Vol.35, No.3 (2013), 212-217. doi:10.1097/MPH.0b013e3182841574 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/32415
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Title
Unrecognized vertebral fractures in adolescents and young adults with thalassemia syndromes
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Abstract
Osteoporosis is a common problem in thalassemics. As the most affected bone is spinal vertebrae, theoretically, it should have the greatest risk of fracture. However, vertebral fracture (VF) in thalassemics was rarely reported. Screening for asymptomatic VF in thalassemics has not been reported. We, therefore, evaluated prevalence of VF in adolescents and young adults with thalassemia. A total of 150 patients with thalassemia, aged 10 years and older were enrolled. Lateral thoracolumbar spine radiography was evaluated. Twenty patients (13%) had VF and 6 of 20 (30%) had multiple VFs. The 2 most common sites of VF were lumbar 1 and thoracic 12 vertebrae. Comparing with the group without VF, thalassemics with VF were older, had more severe degree of thalassemia, history of splenectomy and previous non-VF, more iron chelation use, and longer duration of blood transfusion, but had lower pretransfused hematocrit. Multivariate analysis revealed 2 predictive factors for VF, having severe thalassemia and aged 20 years or older (odds ratio 5.7 and 5.0, respectively). In conclusion, unrecognized asymptomatic VF in thalassemics was not uncommon. Risk factors associated with VF included severe thalassemia and age 20 years or older. Screening for VF in the high-risk patient should be considered. Copyright © 2012 by Lippincott Williams & Wilkins.