PITUITARY AND THYROID INSUFFICIENCY IN THALASSAEMIC HAEMOSIDEROSIS

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Abstract
Thyroid and pituitary function tests using hypothalamic releasing factors were performed in 7 patients with thalassemia and secondary hemosiderosis and in a control group of 7 healthy subjects. The TSH level in the thalassemic patients (18.07 .+-. 1.10 .mu.U/ml) was higher than in the controls (1.01 .+-. 0.14 .mu.U/ml, P < 0.001). After TRH administration the TSH values increased less than in the controls. Serum thyroxine [T4] and free T4 index values were lower in the group of patients with thalassemia (76.7 .+-. 7.8 nmol/l and 19.3 .+-. 2.2) compared to the controls (116.1 .+-. 6.9 nmol/l, P < 0.005 and 38.6 .+-. 3.6, P < 0.001). The basal prolactin values did not differ significantly between the 2 groups, but after TRH administration the increment was significantly lower in thalassemics than in controls (P < 0.005). The basal lutropin values were lower in the thalassemic patients (1.37 .+-. 0.24 ng/ml) than in the controls (3.23 .+-. 0.50 ng/ml) and did not increase significantly after LHRH administration. The FSH values were also lower in the thalassemic group (0.46 .+-. 0.15 ng/ml) compared to the controls (2.06 .+-. 0.08 ng/ml, P < 0.001), and increased only slightly after LHRH administration. In thalassemia pituitary deficiency exists, mostly of gonadotrophs, but possibly also for the thyrotrophs and the lactotrophs. Latent primary hypothyroidism has been found in the thalassemic group. The functional abnormalities found in both endocrine glands are best explained as a consequence of coexisting hemosiderosis.

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