Endocrine Abstracts

Introduction: Endocrine complications are common in beta thalassemia major (BTM) patients receiving blood transfusions. Chelation therapy has a role in preventing such complications. However, patients may have difficulties adhering to chelation therapy. We aimed in this study to determine the endocrine complications in BTM patients.

Methods: This was a descriptive study with cross-sectional data collection over a 6 month period from February 2022 to July 2022, including 43 patients with BTM follow up at Haematology department of Rabta Hospital. The patients underwent a clinical examination and a fasting blood sample was collected for biological measurements.

Results: The mean age was 27±4.78 years. The median duration of erythrocyte transfusions was 25.9±4.75 years. The patients were transfused at a rate of 2 transfusions per week in 65% of cases. Mean ferritin level was 1542.2±594.7 μg/l. Ferritinemia greater than 1000 μg/l was observed in 32 patients (74%). One endocrine complication was found in 35 patients (81%), two endocrine complications was found in 13 patients (30%) and an association of three endocrine complications was found in 3 patients (7%). Fifteen patients developed hypothyroidism (35%). The mean age of patients with hypothyroidism was statistically higher than those with euthyroidism (P=0.023). Diabetes mellitus was found in 14 patients (33%) and prediabetes in 8 patients (19%). BTM patients with prediabetes had statistically higher mean level of ferritinemia (P<0.01). Two patients developed hypoparathyroidism (5%) and nineteen developed hypogonadism (44%). Patients with hypogonadism had statistically higher mean level of ferritinemia (P=0.049). Finally, no cases of adrenal insufficiency were found.

Conclusion: The detection of endocrine and metabolic complications is essential during the follow-up of BTM patients. A monitoring of clinical and biological parameters makes it possible to detect early and sub-clinical abnormalities. Thus, patients will have an early and targeted management.