Endocrinopathies in adult Egyptian thalassemia patients, a cross-section study, single-center experience

Background
Endocrine diseases are common complications in transfusion-dependent thalassemia (TDT). Endocrine disorders are less in nontransfusion-dependent thalassemia (NTDT), but they are still suffering, especially with advancing age. So, all patients with TDT and NTDT need regular screening for evaluation and treatment of endocrinological disorders. The study aims to assess the common endocrinal disorders in patients with thalassemia, TDT and NTDT for early detection and replacement therapy.


Patients and methods
The sectional study included 100 patients with thalassemia: 50 patients who were TDT and 50 patients who were NTDT.
Patients who are more than or equal to 18 years old, have thalassemia major or thalassemia intermedia, patients with or without splenectomy, transfusion-dependent and nontransfusion-dependent patients, all were included in the study.


Results
The study showed that there is a statistically significant positive correlation between serum ferritin and thyroid-stimulating hormone, and there is a negative correlation with sex hormones, serum cortisol, growth hormone level. Also, there is a negative correlation between sex hormones, serum cortisol, growth hormone and frequency of transfusion. The study showed the validity of serum ferritin at a cutoff point of more than 1100 for prediction of patients who are transfusion dependent, with sensitivity of 100% and specificity of 90%.


Conclusion
Thalassemia patients are still suffering from many endocrine disorders, and this necessitates early regular screening, as early identification of endocrinal disorders and use of iron chelation reverse this disorder.