Endocrine Complications

Abstract

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Endocrinopathies in thalassemia - a review

“…A meta-analysis showed that the prevalence of diabetes mellitus, impaired fasting glucose, and impaired glucose tolerances was 6.54%, 17.21%, and 12.46%, respectively [13]. It is another specified type of diabetes, although it shares the insulin deficiency of type 1 and resistance of type2 diabetes [14]. It is common in inadequately iron chelated patients, but is also seen in well transfused and regularly chelated patients.…”

“…Hypothyroidism is a prevalent endocrine complication in TM, which occurs more frequently in the second decade of life [16]. The spectrum of thyroid dysfunction in patients with TM ranges from subclinical hypothyroidism (the most prevalent abnormality) to primary as well as secondary hypothyroidism [14]. Thyroid dysfunction arises mostly due to gland infiltration, direct iron cytotoxicity, chronic tissue hypoxia, free radical injury and organ siderosis.…”

“…Thyroid cancer along with other malignancies like hepatocellular carcinoma and haematological malignancies are emerging issues for the thalassemia patients with increased life expectancy following regular transfusions, adequate chelation and treating complications. Though studies did not find any correlation between the thyroid dysfunction and factors like duration, amount of blood transfusion, serum ferritin level and iron chelation therapy [14], periodic assessment of iron overload, thyroid function and follow up to improve adherence to chelation are strongly recommended.…”

Evaluation of Reproductive Hormones in Patients with ?-Thalassemia Major in Misan Province, Iraq

“…Before the introduction of regular blood transfusion and before the availability of iron chelation therapies β-thalassemia major patients died within the first few years [2,3] . This bad prognosis changed since the survival rates, and life expectancy started to improve progressively and patients may survive until 4 th -5 th decades due to the implementation of continuous and significant advent of diagnostic and therapeutic method, consisting mainly of an intensive transfusion program combined with chelation regimes and imaging method [4,5,6,7] .…”

“…The most serious disadvantage of life-saving transfusions is the inexorable accumulation of iron within tissues and high incidence of endocrine abnormalities in children, adolescents and young adults [4,5] .…”