Citation: Khoshkbarforooshan M, Setoudeh A, Mohsenipour R, Safari A, Kompani F and Rostami P. Comparison of Oral Iron Chelation Therapy Versus the Injectable Once for the Decrease Some Endocrinopathy in β-Thalassemia Major Patients. Austin J Endocrinol Diabetes. 2018; 5(1): 1058. Austin J Endocrinol Diabetes - Volume 5 Issue 1 - 2018 ISSN : 2381-9200 | www.austinpublishinggroup.com Rostami et al. © All rights are reserved Austin Journal of Endocrinology and Diabetes Open Access Abstract Objective: Blood transfusion and iron chelators are necessary for the survival of patients with β-thalassemia but endocrinopathies due to iron overload can decrease the life expectancy in these patients. Moreover, the injectable iron chelators lead to discomfort and poor compliance among the patients compared the oral one. Material and Methods: Seventy two patients with β-thalassemia major from April 1997 to August 2017 at the Children’s Medical Center Hospital in Tehran, Iran, enrolled to this study. Patients were divided into two groups according to the type of chelator. Group1 (39 patients) received oral iron chelator while the group2 (33 patients) received the injectable once. Result: Seventy two patients, 51% female and 49% male were evaluated. The mean age of the patients was 20.4±5.9 years. Prevalence of IGT, DM and clinical and subclinical hypothyroidism were 17.94%, 5.1%, 17.4%, and 25.64% in group 1 and 18.1%, 9.02%, 24.5% and 24.3% in group 2 respectively. There was no case of hypoparathyroidism and twenty patients had no endocrine complications. Conclusion: The lack of a difference in the incidence of some endocrinopatheis between the two groups (injectable and oral iron chelator) offered use of painless and high compliance oral iron chelator instead of injectable once. Keywords: Endocrine complication; β-thalassemia major; Iron chelator; Deferiprone; Deferoxamine Introduction β-thalassemia major is a hereditary hemoglobinopathy due to defect in the production of β-globulin chain. Te most common manifestations of disease are anemia and hepatospelenomegaly (due to extramedullary hematopoiesis). Te mainstay of treatment of the β-major thalassemia is frequent blood transfusion that leads to iron overload in the critical organs include; liver, heart and endocrine glands [1,2]. Iron chelators for attenuated of iron overload in body are used in two ways: injectable (subcutaneous deferoxamine) and recently oral once (Deferiprone; L1). Deferiprone is well inserted into the cell and removes iron, so is more efective than defroxamine in reducing endocrine complications and cardiac iron overload [3,4]. Endocrinopatheis is one of the most common complications due to iron overload and approximately, 60% patients have at least one endocrine organ involvement [5]. Tere are a few studies compare efcacy of oral and injectable iron chelator for decrease endocrine complications in β-thalassemia major patients. Here, we compared some endocrinopathies include: IGT (impared glucose tolerance), DM (diabetes mellitus), hypoparathyroidism (clinical and subclinical) and hypothyroidism in the patients with β-thalassemia major who received oral chelators against the injectable once. Research Article Comparison of Oral Iron Chelation Therapy Versus the Injectable Once for the Decrease Some Endocrinopathy in β-Thalassemia Major Patients Khoshkbarforooshan M 1 , Setoudeh A 1 , Mohsenipour R 1 , Safari A 2 , Kompani F 2 and Rostami P 1 * 1 Division of Endocrinology and metabolism, Tehran University of Medical Sciences, Iran 2 Division of Hematology and oncology, Tehran University of Medical Sciences, Iran *Corresponding author: Parastoo Rostami, Division of Endocrinology and metabolism, Tehran University of Medical Sciences, Iran Received: December 05, 2017; Accepted: January 02, 2018; Published: February 16, 2018 Patients and Methods Seventy two patients with homozygote β-thalassemia major were included to this study. Te patients were treated at the Children’s Medical Center Hospital, Tehran, Iran, from April 1997 to August 2017. Β-thalassemia major was diagnosed in the early of life by standard methods of peripheral blood smear and hemoglobin electrophoresis. Individual characteristics and type of used iron chelator were collected in the specifc questionnaire. All of the patients were divided into two group 1(received oral iron chelator; Deferiprone or L1) include; 39 patients (38.46% male and 61.53% female) with age average of 19.5 years and group 2 (received injectable iron chelator; deferoxamine) include; 33 patients (60.6% male and 39.3% female) with mean age of 21.3 years. Deferiprone therapy was started 6 to 65 months (mean 29.9 ± 11.2 months) afer receiving deferoxamine therapy from early age. Te endocrine functions were evaluated for all the patients before and afer of Deferiprone therapy. Fasting plasma glucose levels 110- 125 mg/dl or 140-199 mg/dl afer OGTT (oral glucose tolerance test 2 hours) was considered IGT (impaired glucose tolerance). Fasting blood glucose levels greater than 126 mg/dL or OGTT more than 200 mg/dl or presence of the symptoms of diabetes and plasma glucose concentrations greater than 200 mg/dL, were regarded to have