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Updated: Jun 5, 2026
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Evaluation of growth, puberty and endocrine dysfunctions in relation to iron overload in multi transfused Indian
Rashid H Merchant1, Amruta Shirodkar, Javed Ahmed
1Dr. Balabhai Nanavati Hospital, Vile Parle (W), Mumbai 400056, India. deandoc2000@hotmail.com
Insights
Growth abnormalities and endocrine dysfunction are common in multi-transfused children with Thalassemia Major. Early detection and treatment are crucial for preventing permanent damage.
Area of Science:
- Pediatrics
- Endocrinology
- Hematology
Background:
- Thalassemia Major requires frequent blood transfusions, leading to iron overload.
- Iron overload can cause significant endocrine and growth complications in affected children.
Purpose of the Study:
- To assess the prevalence of growth abnormalities and endocrine dysfunction in multi-transfused Thalassemia Major patients.
- To correlate these findings with body iron stores.
Main Methods:
- Cross-sectional study of 35 Thalassemia Major patients (aged 13-24 years).
- Clinical assessment of growth and puberty.
- Laboratory evaluation of hormone levels (FSH, LH, testosterone, estradiol, TSH, PTH, Vitamin D, IGF-1).
Main Results:
- High prevalence of short stature (57.14%) and failure to attain puberty (60%).
- Significant rates of primary amenorrhea (87.5% in girls), hypogonadism (low testosterone/estradiol), and altered thyroid/parathyroid function.
- Low IGF-1 levels (51.43%) and Vitamin D deficiency (92.8% of those with high PTH) were observed.
Conclusions:
- Short stature and hypogonadism are frequent in multi-transfused Thalassemia Major patients.
- Vigilant clinical and hormonal evaluation is necessary for early detection and management of endocrine dysfunction.
- Adequate chelation therapy from early life is recommended to prevent endocrine gland damage.
Objective:
To determine the prevalence of growth abnormality and endocrine dysfunction in a group of multi transfused thalassemic children and to correlate these with their body iron stores.
Methods:
This cross sectional study included 35 Thalassemia Major patients, aged 13 to 24 years. Growth and puberty were assessed clinically and the laboratory values of various hormone levels were stratified with their age and sexual maturity.
Results:
57.14% patients were short, 60% had not attained puberty, and 87.5% of the girls had primary amenorrhea. 14.29% had low FSH and 2.86% low LH levels. 89.47% of the boys had low free testosterone and 43.75% of the girls had low estradiol levels. While 20% had high TSH levels, 40% had high PTH levels, of which 92.8% had low levels of Vitamin D. Low levels of IGF-1 were noted in 51.43%.
Conclusions:
In this study analysis, short stature and hypogonadism were frequent findings. These results support the need for vigilant clinical evaluation of growth and puberty, as well as appropriate hormonal evaluation in poly transfused thalassemic children in order to detect and treat endocrine dysfunction early. The authors also recommend aggressive and adequate chelation from early life so that permanent damage to the endocrine glands can be prevented.
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