Hearing loss in Iron chelated Thalassemic patientin Udonthani Hospital
Keywords:
thalassemia, iron chelation, hearing lossAbstract
Background: Thalassemia is a common disease in Thailand. Patients with thalassemia who need regular blood transfusions often develop iron overload which requires treatment with iron chelation. Following iron overload treatment, hearing loss has been reported with iron chelation, but the incidence and definitive risk factors for hearing loss are unknown.
Objectives: To determine the prevalence and the risk factors of hearing loss in thalassemia patients receiving iron chelation drugs in Udon Thani Hospital.
Methods: A retrospective study collecting data from medical records of thalassemia patients receiving iron chelation drugs in Udon Thani Hospital. From January 1, 2017 to July 15, 2022 and continue to follow up on treatment, collect demographics and thalassemia data, treatment results and hearing test results (audiogram auditory steady-state reponse: ASSR and distortion product otoacoustic emission: DPOAE). Data were analyzed using STATA (version 15).
Results: 100 patients, 50 males (50%), mean age 9.51 years, 28 (28%) patients with thalassemia. Patients in the abnormal hearing test group had beta-thalassemia hemoglobin E 10%, a mean pre-treatment ferritin level of 1757.72 ng/ml and a mean serum ferritin level greater than 1000 ng/ml was 55.25 months. The mean deferoxamine (DFO) dose was 25.84 mg/kg/day, mean DFO duration was 25.14 months. The mean deferiprone (DFP) was 82.68 mg/kg/day, mean DFP duration was 31.44 months The mean deferasirox (DFX) was 23.29 mg/kg/day period, mean DFX duration was 16 months, this data were not different from the normal hearing group (p-value > 0.05). The number of hearing loss in 35 ears was at 8000 Hz, which was the most at 42.85%. This study found that sex, age, weight, type of thalassemia, ferritin level before receiving iron chelation, ferritin level before the hearing test, duration of ferritin level greater than 1000 ng/ml, type of iron chelation, neither was a risk factor for hearing loss (p-value > 0.05).
Conclusion: The prevalence of hearing loss was 28 percent, with most hearing loss at a frequency of 8000 Hz, and no obvious risk factors for hearing loss were found in this study (p-value > 0.05).
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