Evaluation of puberty in relation to iron overload in multi transfused B-thalassemia patients

Objective; Prospective study to determine the prevalence of delayed puberty in thalassemia major patients in Sohag University Hospital. This study also aimed to determine serum gonadotropin and sex hormone levels in these patients and correlate these to their serum ferritin. Methods; This cross sectional study included 30 Thalassemia Major Patients, aged 12 to 18 years. Puberty was assessed clinically and the laboratory values of various hormone levels were stratified with their age and sexual maturity. Relation between serum ferritin level and sex hormone was assessed. Results. of 30 patients, 66.7% had not attained puberty, and 100% of the girls had primary amenorrhea. F.S.H level was 1.45 ±1.88 mIU/ml before giving gonadotropin hormone analogue and after 4 hours of giving hormone, it was 3.78 ±4.19 mIU/ml. LH level before giving gonadotropin hormone analogue was 1.91 ±4.79 mIU/ml, while after 4 hours it was 6.52 ±7.50 mIU/ml. 88.24% of male cases had low serum testosterone level. 84.62% of female cases had low serum estradiol level. Correlation between serum ferritin with F.S.H, L.H, estradiol, testosterone before and after giving G.N.R.H analogue were statistically insignificant. Conclusions. Hypogonadism was frequent findings. The results support the need for vigilant clinical evaluation of puberty, as well as appropriate hormonal evaluation in poly transfused thalassemic children in order to detect and treat endocrine dysfunction early. The authors also recommend aggressive and adequate chelation from early life so that permanent damage to the endocrine glands can be prevented. [Alzahraa EA.Sharaf, Safaa H. Ali and Hasnaa A.Abo-Elwafa. Evaluation of puberty in relation to iron overload in multi transfused B-thalassemia patients. J Am Sci 2014;10(11):1-7]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 1