Introduction: Blood transfusion is critical for survival in Thalassemia major. Hypertransfusion therapy increased the frequency of complications due to iron overload. The aim of this study was evaluation of endocrine disturbances in patients with thalassemia major older than 10 years old.
Materials and methods: Fifty six patients with thalassemia major greater than 10 years enrolled. Patients have been examined to determine their pubertal status and standard deviation score of height for evaluation of short stature. For evaluation of glucose tolerance, fasting blood glucose and oral glucose tolerance test were performed. Evidence for diabetes mellitus was American Diabetes Association and World Health Organization criteria. Serum level of calcium, phosphorous, thyroid stimulating hormone, free thyroxin, luteinizing hormone, and follicular stimulating hormone, estradiol in girls and testosterone in boys were measured.
Results: Fifty-six patients with thalassemia were evaluated (mean age15.62±4.44 years). In this study prevalence of diabetes mellitus was 5 patients (8.9%), impaired fasting glucose was 16 patients (28.6%) and impaired glucose tolerance test was 4 patients (7.1%). Short stature (SDS≤−2) was seen in 25 patients (70%) of boys and 14 patients (73%) of girls. Impaired puberty occurred in 40 patients (71%) of our patient. Hypocalcaemia and primary overt hypothyroidism were present in 23 patients (41%) and 9 patients (16%) respectively.
Conclusion: Despite therapy with Desferal in the management of beta-thalassemia the risk of secondary endocrine dysfunction remains high. Hypogonadism is one of the most frequent endocrine complications. Endocrine evaluation in patients with thalassemia major must be carried out regularly.
25 - 29 Apr 2009
European Society of Endocrinology