Assessment of serum calcium levels and its outcome among transfusion dependent beta thalassemia major patients on chelation therapy

Objective: To analyze the serum calcium levels and its outcome among blood transfusion dependent β-Thalassemia major patients on chelation therapy. Material and Methods: cross-sectional study design was employed to conduct the study. A total of 250 children diagnosed (5-12 years old) with beta thalassemia major undergoing regular blood transfusions, presented to the pediatric ward of CMH Bahawalpur between June 2024 and June 2025 were included in the study. The approval of the ethical review board and written informed consent of the respondents and their guardians were obtained for conducting the study. The patients with their guardians were then approached for data collection. Laboratory analysis of the fresh blood samples of the patients, under aseptic measures, was conducted for serum calcium levels with the documentation of results. Results: This study found a significant association between hypocalcemia and the occurrence of clinical symptoms in transfusion dependent thalassemia patients. Carpopedal spasm (4.5%), numbness (13.4%), bone pain (46.3%), and fractures (19.4%) were observed exclusively in patients with hypocalcemia, while none of these symptoms were present in those with normocalcemia. The associations were statistically significant, with p-values < 0.05 for all variables except seizures, which were not reported in either group. Conclusion: Hypocalcemia was significantly associated with carpopedal spasm, numbness, bone pain, and fractures in transfusion-dependent thalassemia patients, with females showing a higher burden of complications. Regular calcium monitoring is essential to reduce morbidity in this population. Keywords: Beta thalassemia, Blood transfusion, Chelation therapy, Hypocalcemia.