Endocrine Abstracts

Objectives: Disorders concerning the endocrine system may be seen in patients with transfusion-dependent thalassemia major. It is thought that iron accumulated in the organs, especially with transfusion, causes this. In our study, we tried to reveal a relationship by comparing the iron parameters of these patients with various endocrine parameters.

Methods: Our study is a retrospective study.The data of 18 thalassemia major patients who applied to Osmangazi University Endocrinology and Hematology departments were collected from medical records.Parametres are sex, age, iron parameters, Hba1c, fasting glucose, fructosamine, lipid profile, thyroid function tests, anterior pituitary hormone panel, parathormone (PTH), 25-OH vitamin D level.

Results: 18 patients with thalassemia major were analyzed. 8(44.4%) were male and 10 (55.6%)were female.The mean age was 36.94±10.86 years and the age range was between 20 and 54 years. All of the patients received blood transfusion once a month and were followed up with iron chelation therapy. The fructosamine levels of 6 patients were also above the normal value. GH and IGF-1 levels of the patients were in the normal range. The 25 OH vitamin D level of 11 patients was below 30 ng/ml. Osteoporosis was detected in 9 patients. Seven of these patients (7/9) were evaluated as secondary osteoporosis. Endocrine parameters of the patients were compared with iron parameters. There was a positive relationship between transferrin saturation and 25-OH vitamin D, a negative relationship between iron and PTH, and a negative relationship between ferritin and FSH, LH. Thyroid function tests were normal in 9 patients (50%), primary hypothyroidism was found in 8 patients (44.4%), and hyperthyroidism with graves diagnosis was detected in 1 patient. There was no thyromegaly in thyroid USG. Autoimmunity was only present in the patient diagnosed with graves.

Conclusions: Evaluation of endocrinopathies in thalassemia patients should be done regularly to detect and treat endocrine complications. It may be appropriate to screen these patients at least once a year in this respect. The role of pituitary hormones in the routine follow-up of thalassemia patients is still controversial. Larger prospective studies are needed. Collaborative multicenter studies should be considered to reach more precise information.

Keywords: Thalassemia, endocrinopathy, ferritin, iron, transfusion