Endocrine disorders in patients with sickle cell anemia

ABSTRACT

Red blood cell transfusions are a therapeutic mainstay in Sickle Cell Disease [SCD] and repeated transfusions can result in iron overload. Endocrine dysfunction is the most common and earliest organ toxicity seen in subjects with chronic iron-induced cellular oxidative damage. The aim of the present work is to investigate some of the endocrine functional disorders in patients with SCD. The present study consisted of 30 patients with SCD recruited from the Medical Department of King Fahd Hospital- Hofuf, Eastern Province - Saudi Arabia. Most of the patients had a history of repeated blood transfusions [5 times/year]. Patients were classified into two groups Group I [15 males] and Group 2 [15 females] with mean age for both sex [28.6 +/- 5.4 years]. Thirty age and sex matched normal subjects were, also, included in the study as a control group. Plasma level of testosterone, iron profile, FSH and LH as well as thyroid function tests were assessed. A total of 30 patients with SCD were recruited in the study [15 males and 15 females] with mean age 28.6 +/- 5.4 years. They were compared to a control group of 30 healthy subjects and showed significant difference between group 1 and the control group regarding the level of testosterone [5.03 +/- 3.37 vs 9.65 +/- 1.69; respectively, p=0.05]. Also the level of testosterone showed insignificant correlation with the serum iron level among group 1 [r=-0.18, p=0.5]. A significant lower level in T4 was detected in group 1 compared to the control group [5.17 +/- 3.41 vs 11.01 +/- 1.44; respectively, p=0.001]. There was insignificant correlation between testosterone level in group 1 and the T4 level in the same group [r=-0.01, p=0.89]. On the other hand, no significant difference was detected between group 1 and control group as regard TSH level [p=0.7]. Female patients with SCD [group 2] have a significant lower level of LH than the control group [8.7 +/- 5.44 us 16.2 +/- 2.74; respectively, p=0.001]. The present study revealed that there was no significant difference between the level of FSH among group 2 and the control group [6.19 +/- 3.60 vs 6.4 +/- 1.3; respectively, p=0.8], As regard the correlation between the LH level and the serum iron among group 2, there was no significant correlation [r= -0.35, p =0.18]. Also group 2 showed significant lower level of the T4 than the control group [6.58 +/- 6.3 vs 11.64 +/- 1.05; respectively, p= 0.005]. On the other hand no significant correlation was found between patients and control group as regard TSH level [p=0.1]. There was no significant correlation between the level of T4 and the serum iron level in both group 1 and group 2. The present study has demonstrated that SCD has a depressant effect on the hormone LH in female patients with SCD and T4 in both males and females with SCD irrespective of the serum iron level