54 Erythrocyte Metabolism in Icteric Term and Premature Newborn Infants

Abstract

Hormonal status was assessed in 11 thalassemic children (2 boys and 9 girls) aged 5 to 18 years. All were on a high transfusion regimen and on regular chelation therapy. Investigations were performed in all children prior to transfusion. The following studies provided normal results: glucose and insulin measurements during oral glucose tolerance test; HGH values during insulin tolerance test; ACTH, T3, T4 and TSH basal values. On the other hand, three abnormalities were observed: 1. Cortisol peak values during ITT were low in 4 patients; in these patients, the cortisol response to ACTH was normal. 2. After administration of TRH, mean TSH values were significantly elevated when compared to normal controls. 3. On LHRH test, 5 prepubertal girls out of 6 showed a low response for FSH and 3 out of 6 a low response for LH. One girl with delayed puberty had a low response for both FSH and LH. The 2 girls with normal puberty showed a normal response to LHRH. It is concluded that gonadotrophin reserve assessment is the best way to detect the endocrinological impairment occuring in thalassemic children. The relationship between these disturbances and the iron overload remains conjectural.