Pseudoxanthoma Elasticum-Like in β-Thalassemia Major, a matter of α-Klotho and Parathyroid Hormone?

Pseudoxanthoma elasticum-like (PXL) condition is one of the complications faced by patients with beta-thalassemia major (beta-TM). Histopathological features include abnormal, mineralized and fragmented elastic fibers in skin, eyes and arterial blood vessels (elastorrhexia). The pathogenesis of PXL lesions in beta-TM is not yet completely understood. This study was aimed at analyzing a possible implication of alpha-Klotho in the clinical manifestation of PXL in patients with beta-TM (30 with and 78 without PXL). A significant correlation was observed between Klotho, parathyroid hormone (PTH) and serum calcium (Ca). Our analysis seems to indicate alpha-Klotho and PTH as factors that can affect the development of PXL.