Hema Satwani, Jamal Raza, Alam M, Asim Kidwai.
Endocrinal complications in Thalassemias: Frequency and association with serum ferritin levels.
Pak Paed J Jan ;29(3):113-9.

Objectives: To determine the frequency of endocrinal complications in patients with thalassemia Major, and to seek its association with serum ferritin levels. Design: Cross sectional study. Place & duration of study: Pediatric Endocrine unit II of National Institute of Child Health, Karachi, from June2004-November 2004. Patient & Methods: Thirty-five diagnosed thalassemia major children in the age group 6-21 years meeting the inclusion criteria were included in the study. The association of raised ferritin levels in the increasing ranges of mild, moderate & extreme with the endocrinal abnormalities was studied. Data was collected and tabulated. Chi-square was applied to test the hypothesis using SPSS and p-value of <0.05 was taken as statistically significant. Results: Out of 35 children 20 (10 boys and 10 girls) developed endocrine abnormalities. Mean (SD) age of developing endocrine complications was 12.4yrs ± 15yrs. Twelve children 60% developed one & 8 children 40% developed multiple endocrine complications. Hypocalcemia was observed in 9 children 25.7%, but hypoparathyriodism was seen in 3 children i.e. 8.5%, hypothyroidism was reported in 6 children 17.4% while hypogonadism was detected in 4 children 36.6% out of 11 children. Impaired glucose metabolism was seen in 2 children i.e. 5.7%. Growth hormone function was deficient in 9 children i.e. 40.0% of 22 children with height <-2.5 SDS for age & sex. Growth hormone deficiency and hypogonadism were found to be the two most common complications. Conclusion: We did not find an association between the endocrine dysfunction & the high serum ferritin levels as reported in other studies. This may result from a single ferritin level measured during the year which may not be the true representative of the ferritin levels maintained by the patient during the whole childhood. Apart from that multifactorial nature of endocrine disturbances were probably responsible.

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