Prevalence of growth and endocrine disorders in Malaysian children with transfusion-dependent thalassaemia.
- Author:
Khian Aun TAN
1
;
Su Han LUM
1
;
Abqariyah YAHYA
2
;
Shekhar KRISHNAN
1
;
Muhammad Yazid JALALUDIN
1
;
Way Seah LEE
1
Author Information
- Publication Type:Journal Article
- Keywords: endocrine disorders; iron overload; transfusion-dependent thalassaemia
- From:Singapore medical journal 2019;60(6):303-308
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Endocrine dysfunction due to iron overload secondary to frequent blood transfusions is a common complication in children with transfusion-dependent thalassaemia (TDT). We ascertained the prevalence of endocrine dysfunction in children with TDT seen in a hospital setting in Malaysia.
METHODS:We reviewed all patients with TDT who had ≥ 8 blood transfusions per year. Patients who had a history of stem cell transplantation, concurrent autoimmune diseases or were newly diagnosed to have TDT were excluded. Standard diagnostic criteria were used in the diagnosis of various endocrine dysfunctions.
RESULTS:Of the 82 patients with TDT, 65% had at least one endocrine dysfunction. Short stature was the commonest (40.2%), followed by pubertal disorders (14.6%), hypoparathyroidism (12.3%), vitamin D deficiency (10.1%), hypocortisolism (7.3%), diabetes mellitus (5.2%) and overt hypothyroidism (4.9%). Subclinical hypothyroidism and pre-diabetes mellitus were seen in 13.4% and 8.6% of the patients, respectively. For children aged < 10 years, the prevalence of both thyroid dysfunction and hypoparathyroidism was 9.1%.
CONCLUSION:Two-thirds of children with TDT experienced at least one endocrine dysfunction. Thyroid dysfunction and hypoparathyroidism may be missed if endocrine screening is only performed in children with TDT > 10 years of age. Close monitoring for endocrine dysfunction and hormonal therapy is essential to prevent long-term adverse outcomes.
