Endocrine Dysfunctions in Iron Overload in Patients with Major Thalassemia

Abstract Background The aim of the present study was to determine the endocrine dysfunction in patients with major thalassemia, who receive hyper transfusion. Materials and Methods This cross sectional study was performed during one year, which included 65 major thalassemia patients (31 females and 34 males), aged between 14 month to 27 years old (median 10,3). Growth assessment was measured by height and weight according to age and BMI. For all patients serum ferrites concentration, serum calcium and phosphorus, alkaline phosphates, fasting blood sugar, thyroid stimulating hormone, free thyroxin, FSH, LH, dehydroepiandrosterone sulfate, testosterone, estradiol were measured. Results In this study, 44.9% of patients were found to be shorter than the height of 5th percentile for their age. Diabetes mellitus and impaired fasting glucose were seen in 16% and 28.6% of patients respectively. There was significant correlation between serum ferritin level and impaired glucose tolerance test (p-value =0.043) in them. Frequency of hypocalcaemia and hyperphosphatemia were 36.9% and 10.7% respectively. Frequency of hypogonadism was 54.8%. Fourthy percent of the patients had no endocrine abnormalities. Conclusion Endocrine dysfunctions are extremely frequent in patients with thalassemia, but chelating therapy can prevent or limit these complications. Impaired glucose tolerance was one of the most frequent endocrine complications, which were related to ferritin level. Key Words Endocrine System, beta-Thalassemia, Ferritins