Thesis (Ph.D.) - Cairo University - Faculty of Science - Department of Biochemistry

The deleterious effect of iron overload on anti-müllerian hormone (AMH) level, as a best test to investigate ovarian reserve, was evaluated in 90 female patients with thalassemia major (TM), intermedia (TI) and minor, osteoporosis detection through measurement of bone mineral density (BMD z-score) using DXA and laboratory diagnosis. Also, to investigate the effects of iron chelation therapy including deferiprone and deferoxamine in the management of transfusion-related iron overload. The present results revealed that Serum AMH level was lower in female patients with transfusion dependent Ý-thalassemia than in thalassemia minor also, Ferritin was 25 fold more in thalassemia major compared to thalassemia minor (3088.0±2497.6 ng/ml vs. 120.3±36.2 ng/ml). There was significant negative correlation of AMH with ferritin in all thalassemic females. The prevalence rate of osteoporosis, based on the WHO criteria was 3.3% in thalassemia major and the prevalence of osteopenia was 93.3% in thalassemia major and 30% in thalassemia intermedia. The present finding implied a significantly higher ferritin, higher PTH, higher osteocalcin and lower AMH in patients with thalassemia major that used deferoxamine than deferiprone. In conclusion, patients with thalassemia major and intermedia constitute a high risk group due to higher ferritin concentrations and iron overload

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