Pituitary Iron Deposition and Endocrine Complications in Patients with β-Thalassemia: From Childhood to Adulthood

Hemoglobin. 2020 Sep;44(5):344-348. doi: 10.1080/03630269.2020.1812636. Epub 2020 Sep 8.

Abstract

The endocrinological complications are a great concern in transfusion-dependent β-thalassemia (β-thal) patients. The pituitary iron deposition is regarded as the main cause of hormonal changes in thalassemic patients. In this study, our aim was to explore the association between endocrinological complications and pituitary iron overload by magnetic resonance imaging (MRI). Fifty transfusion-dependent thalassemia (TDT) patients were recruited for the study. Pituitary MRIs of patients were taken using a 1.5 Tesla Philips MRI machine. There was at least one clinical endocrine complication in two of three patients. The iron accumulation was moderate in the liver (60.0%) and was mild in hypophysis (16.0%) and in heart (8.0%). The hypogonadism and diabetes mellitus (DM) were not seen with a significantly increased pituitary iron burden. The hypogonadism was related to cardiac iron deposition (p = 0.04). The short stature was associated with a hepatic iron overload (p = 0.05). The conventional follow-up of patients with TDT might be inadequate and screening of patients with MRI of hypophysis along with heart and liver leads to better results.

Keywords: Endocrinological complications; magnetic resonance imaging (MRI); pituitary iron; transfusion-dependent thalassemia (TDT).

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Biomarkers
  • Blood Transfusion
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Iron / metabolism*
  • Iron Overload / diagnostic imaging
  • Iron Overload / etiology*
  • Iron Overload / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pituitary Gland / diagnostic imaging
  • Pituitary Gland / metabolism*
  • Pituitary Gland / pathology*
  • Young Adult
  • beta-Thalassemia / complications*
  • beta-Thalassemia / therapy

Substances

  • Biomarkers
  • Iron