Endocrine Disorders in Patients with Sickle Cell Anemia
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- Category: Vol. 77, June 2009
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Endocrine Disorders in Patients with Sickle Cell Anemia,NASHWA A. EL-SARRAF and AHMAD M. SULAIMAN
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.
Methods: The present study consisted of 30 patients with SCD (proved by hemoglobin electrophoresis from the start of the condition) 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 1 (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 for group 1 and male control group, FSH and LH for group 2 and female control group. Complete blood count, biochemistry, iron profile, as well as thyroid function tests were assessed for both group 1 and 2 and control group.
Results: 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 no significant difference between group 1 and the control group regarding the level of testoster-one (5.03±3.37 Vs 6.95±1.69; respectively, p=0.05). Also the plasma level of testosterone showed insignificant correlation with the serum iron level among group1 (r=-0.18, p=0.5). A significant lower level in T4 was detected in group1 compared to the control group (5.17±3.41 Vs. 11.01±1.44; respectively, p=0.001). There was insignificant correlation between test-osterone level in group 1 and the T4 level in the same group (r=-0.01, p=0.89). On the other hand, no significant correlation was detected between group 1 and control group as regard TSH level (p=0.3).
Female patients with SCD (group 2) have a significant lower level of LH than the control group (72±5.44 Vs. 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=0.05), 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= 0.001). On the other hand no significant correlation was found between patients in group 2 and control group as regard TSH level (p=0.3).
There was no significant correlation between the level of T4 and the serum iron level in both group 1 and group 2 (p= 0.5).
Conclusion: The present study had demonstrated that SCD had 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.