Hypogonadotropic Hypogonadism in Hemochromatosis: Recovery of Reproductive Function After Iron Depletion

Siemons, Laurens; Mahler, C.

doi:10.1210/jcem-65-3-585

Cited by 54 publications

(22 citation statements)

References 13 publications

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“…However, in view of the reports of reversal of hypogonadocropism with phlebotomy (23,24) and of the diagnosis of chis disease in ics earliest stages with such techniques as HLA typing (4-6), prospective study of the funwon of the hypochalamo-pitu1cary-gonadal axis, and indeed all aspects ofhypothalamopitu1cary func.cion, 111 early hemochromatos is will be necessary to help judge the effectiveness of rherapy. …”

Section: Discussionmentioning

confidence: 99%

Hypothalamic Hypogonadism in Hemochromatosis: A Case Report

Matwijiw

Iliffe

Mehta

et al. 1988

Canadian Journal of Gastroenterology

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A 42-ycar-olJ man developed hypogonadorroptc hypogonadism due to primary hemochromatosis. Endocrine cvaluarion indicated a hvpothalamic defccr in rhe control of gonadorropin secretion. Although cirrhosis was present on liver biopsy, ocher major features of the hemochromatosis syndrome were not manifest. Parienrs with hemochromacosis arc now being diagnosed at earlier stages of disease. Clinicians should be alert to possible early development of hypochalamopituitary dysfunction and should be prepared co perform derailed cndocrinological investigations in such patients. Can J G a stroentero l 1988; 2(1): 3 1-34

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Section: Discussionmentioning

confidence: 99%

Hypothalamic Hypogonadism in Hemochromatosis: A Case Report

Matwijiw

Iliffe

Mehta

et al. 1988

Canadian Journal of Gastroenterology

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“…In persons with severe iron overload due to hemochromatosis, iron deposits were visualized in a minority of thyrotrophs; the deposits were much less prominent than those in gonadotrophs (22,23). There are few welldocumented hemochromatosis patients who had hypothyroidism due to impaired thyrotroph function; most of them also had hypogonadotrophic hypogonadism (24)(25)(26)(27)(28)(29). In rare cases, secondary hypothyroidism resolves after therapeutic phlebotomy to achieve iron depletion (29).…”

Section: Barton Et Almentioning

confidence: 99%

Thyroid-Stimulating Hormone and Free Thyroxine Levels in Persons with HFE C282Y Homozygosity, a Common Hemochromatosis Genotype: The HEIRS Study

Barton¹,

Leiendecker–Foster

Reboussin

et al. 2008

Thyroid

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for the Hemochromatosis and Iron Overload Screening Study Research InvestigatorsBackground: Relationships of thyroid and iron measures in large cohorts are unreported. We evaluated thyroidstimulating hormone (TSH) and free thyroxine (T4) in white participants of the primary care-based Hemochromatosis and Iron Overload Screening (HEIRS) Study. Methods: We measured serum TSH and free T4 in 176 HFE C282Y homozygotes without previous hemochromatosis diagnoses and in 312 controls without HFE C282Y or H63D who had normal serum iron measures and were matched to C282Y homozygotes for Field Center, age group, and initial screening date. We defined hypothyroidism as having TSH >5.00 mIU=L and free T4 <0.70 ng=dL, and hyperthyroidism as having TSH <0.400 mIU=L and free T4 >1.85 ng=dL. Multivariate analyses were performed using age, sex, Field Center, log 10 serum ferritin (SF), HFE genotype, log 10 TSH, and log 10 free T4. Results: Prevalences of hypothyroidism in C282Y homozygotes and controls were 1.7% and 1.3%, respectively, and of hyperthyroidism 0% and 1.0%, respectively. Corresponding prevalences did not differ significantly. Correlations of log 10 SF with log 10 free T4 were positive ( p ¼ 0.2368, C282Y homozygotes; p ¼ 0.0492, controls). Independent predictors of log 10 free T4 were log 10 TSH (negative association) and age (positive association); positive predictors of log 10 SF were age, male sex, and C282Y homozygosity. Proportions of C282Y homozygotes and controls who took medications to supplement or suppress thyroid function did not differ significantly. Conclusions: Prevalences of hypothyroidism and hyperthyroidism are similar in C282Y homozygotes without previous hemochromatosis diagnoses and controls. In controls, there is a significant positive association of SF with free T4. We conclude that there is no rationale for routine measurement of TSH or free T4 levels in hemochromatosis or iron overload screening programs.

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“…5 No. [2][3] Hipogonadizrn, hemokromatozlu erkeklerde çok sık görülen bir endokrin bozukluktur (1,2). Hipogonadizm; hipofizde FSH ve LH salgılayan hücrelerde veya hipotalamustaki GnRH (Gonadotropin Releasing Hormon) salgılayan hücrelerde, demirin birikimi sonucu hasara uğramasma bağlı GnRH yetmezliği ile ortaya çıkan bir klinik tablodur (3,4).…”

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“…Hipogonadizm; hipofizde FSH ve LH salgılayan hücrelerde veya hipotalamustaki GnRH (Gonadotropin Releasing Hormon) salgılayan hücrelerde, demirin birikimi sonucu hasara uğramasma bağlı GnRH yetmezliği ile ortaya çıkan bir klinik tablodur (3,4). Hemokromatozda; demir birimine bağlı olarak gelis,en hücresel hasar sonucu hipogonadotropik hipogonadizmin oluştu ğu belirtilmiştir (2). ünceleri hipogonadizimin bu formu irreversibil olarak kabul edilip testosteron ile tedavi edilirken, son yıllarada sadece sık aralıklarla uygulanan flebotobinin yeterli olabileceği belirtilnüştir (2,5,6 …”

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