Endocrine Complications and the Effect of Compliance to Chelation Therapy in Patients with Beta Thalassemia Major in Eastern Province of Saudi Arabia 

Background: Endocrinopathies and metabolic complications are common in Beta Thalassemia major patients receiving blood transfusion. Chelation therapy has a role in preventing or delaying such complications. However, patients may face difficulties to adhere with chelation therapy due to several reasons. Aim: To evaluate endocrine complications in beta thalassemia major patients (2-30 years) in The Eastern Province of Saudi Arabia and compare the onset of endocrine complications among compliant and non-compliant patients. Moreover, assess the barriers that hinder the compliance on chelating therapy. Methods: : A Cross-sectional study was conducted on 89 patients (43 male and 46 females) in patients aged 2 to 30 years attending different hospitals in the Eastern province of Saudi Arabia. A semi-structured questionnaire was used to collect demographic data, medical histories. The questionnaires were filled by face-to-face interviews with the patients, or their care givers and the required laboratory data was retrieved from the medical records of patients. Results: : The most prevalent abnormality was underweight detected in (40.9 %) of patients followed by subclinical hypothyroidism (37.7 %), short stature (35.2 %), hypothyroidism in (17.0 %) and diabetes mellitus in (13.6 %). Significant difference between those who are compliant to iron chelation therapy and those who are not in terms of the prevalence of short stature (P value= .05) and hypothyroidism (P value= .05) being the most evident. Percentage of Patients who were not compliant on taking chelation therapy is (21.6 %) and (9.1 %) of patients were not taking them at all. Conclusion: Despite the role of chelation therapy in the management of iron overload, the risk of secondary endocrine and metabolic complications remained considerable. Subclinical hypothyroidism and short stature were the most frequent endocrine complications encountered in this study.