Background: Frequent blood transfusions and iron overload lead to many complications in patients with -thalassemia major. Endocrine disorders are detected in these patients with a high frequency. Early diagnosis and treatment of these complications could result in improvement of quality of life.
Patients and methods: A total of 183 patients with thalassemia major aged between 10 and 22 years old were evaluated for endocrinopathy. Blood samples were taken for determination of serum T4, TSH, FBS, Ca, Ph, cortisol, FSH, LH, estradiol and testosterone levels.Medical charts were used to assure the regularity of blood transfusion and serum ferritin levels. Data were analysed using chi-square, independent t-test, ANOVA and logestic regression.
Results: In 62.29% of patients at least one form of endocrinopathy (other than delayed puberty) was detected. Other endocrinopathies in order of frequency were: growth failure (36.06%), hypoparathyroidism (16.93%), adrenal insufficiency (12.50%), diabetes mellitus (11.47%) and hypothyroidism (8.74%).
There was no significant relation between serum ferritin levels and endocrine disorders; except delayed puberty in males (P=0.030) and hypoparathyroidism in both genders (P=0.040). Although there was no relation between endocrinopatheies and the age at which Desferal therapy was introduced, there was a significant relation between both growth failure and diabetes mellitus with gender (P value=0.007 and 0.013, respectively).
Conclusion: This study showed that patients with thalassemia major (are) affected by multiple endocrine disorders. Only some of these endocrinopathies have association with increased levels of serum ferritin. Therefore, patients with thalassemia major need to be evaluated for endocrine disorders periodically, even when serum ferritin levels are normal.
03 - 07 May 2008
European Society of Endocrinology