Retrospective evaluation of endocrine complications during treatment in patients with childhood beta thalassemia major, beta thalassemia intermedia and sickle cell anemia

In this study, we aimed to evaluate the endocrine complications developed during treatment in patients diagnosed with beta thalassemia major (BTM), beta thalassemia intermedia (BTI) and sickle cell anemia (SCA). Data of 96 patients diagnosed with BTM, BTI and SCA who applied to Uludağ University Pediatric Hematology Outpatient Clinic between 2016 and 2020 were retrospectively evaluated. Two patients were excluded due to insufficient data. In our study, 66 patients (70%) were being followed up with a diagnosis of BTM, 16 patients (17%) with a diagnosis of BTI, and 12 patients (13%) with a diagnosis of SCA. Short stature in 35 patients (37%), hypogonadism in 28 patients (30%), clinical hypothyroidism in 10 patients (11%), diabetes mellitus in 8 patients (9%), dyslipidemia in 55 patients (59%), hypoparathyroidism in 3 patients (3%), osteoporosis in 49 patients (52%), osteopenia in 18 patients (19%), adrenal insufficiency in 1 patient (1%) and insulinoma in 1 patient (1%) were detected. The rate of short stature was higher in patients with hypothyroidism and / or hypogonadism. The rate of hypogonadism was found to be high in those with short stature and those with hypothyroidism. A significant relationship was found between splenectomy and hypogonadism, hypothyroidism, and diabetes mellitus. Patients with dyslipidemia and osteoporosis had a high rate of mild hepatic iron deposition. The rate of fracture was high in patients with osteoporosis. The incidence of at least 1 endocrinological complication was higher in BTM patients compared to SCA patients. Patients with at least 1 endocrinological complication had lower mean age and mean ferritin values. These results have shown that various endocrinological complications may develop during treatment in BTM, BTI and SCA patients, and these complications cause serious morbidities, so a close cooperation with the endocrinologist is required in the follow-up of the patients.