ABSTRACT
Introduction: Sickle Cell Disease, Hemoglobinopathy which often requires frequent blood transfusions, is an excessive deposition of iron in the tissues, often resulting in endocrine disorders. This study aimed to determine the prevalence of endocrinopathies and metabolic disorders in patients suffering from sickle cell anemia in Kerman
Materials and Method: This cross-sectional study was conducted on 66 patients, suffering from sickle cell anemia. An information form was completed for all patients and blood samples were obtained for laboratory tests such as fasting blood sugar, serum TSH level, free T4 level, serum LH and FSH levels, serum PTH, total Ca, P and serum prolactin levels. Serum testosterone- and serum estradiol levels were checked separately, based on gender. Results were compared with normal laboratory tests, and statistically analyzed
Results: In this study, sickle cell anemia patients, aged 14-59 were evaluated. None of the patients had diabetes mellitus. Hypothyroidism was observed in 24.2% of patients, hypoparathyroidism in 12.5%, hypogonadism in 21.2% and hyperprolactinemia in 53%. Overall, 65.1% were found to be suffering from endocrine disorders. Statistically significant differences were seen between endocrinopathies and age
Conclusion: Results showed age to be the important factor in endocrine disorders. Timely and appropriate treatments [including blood transfusion and receiving iron chelators] can evidently reduce iron overload in these patients and prevent its endocrine complications
ABSTRACT
Hypothyroidism is a relatively common disease, and patients are often treated with levothyroxin; however when high doses of levothyroxin are needed for its treatment of hypothyroidism, we should carefully consider the reasons. A 43 year old woman, suffering from uncontrolled hypothyroidism, referred to an endocrine clinic, was treated with 1000 microgram levothyroxin and 150 microgram liothyronin tablets. She admitted to hospital with a likely diagnosis of levothyroxin false malabsorbtion to take the levothyroxin loading test. Serum T4 was measured at 0, 30, 60, 120 and 240 minutes after levothyroxin consumption and showed increases in serum T4 level was 0.9, 1.2, 1.4, 2.3, 2.6 micro g/dL respectively. Absorption of T4 was normal in the small bowel, due to false levothyroxin malabsorbtion that had occurred because of irregular drug consumption. Levothyroxin loading test can differentiate between true and false malabsorbtion. Considering the high prevalence of psychological symptoms, depression in particular, in hypothyroid patients who do not responsd to treatment despite increased the doses of levothyroxin, levothyroxin malabsorbtion needs to be researched, especially the false type and following a definite diagnosis, appropriate treatment can be prescribed