Growth and puberty disorders in major thalassaemic patients in Hormozgan

Growth and puberty disorders and endocrine abnormalities are seen in major thalassaemia in the background of chronic anemia or iron retention following transfusion. In a case-control study, 109 thalassaemic patients, aged 8 to 18 years, were compared with 107 healthy individuals in the same age range in order to evaluate growth and puberty state and detecting high risk age groups. Thalassaemic patients were divided into good control (ferritin <1500 ng/dl) and poor control (ferritin >1500 ng/dl) groups. Only 14% of thalassaemic patients were in good control group. Short stature [SDS (Standard Deviation Score) less than -2.5] was seen in 64% of patients. Statistically significant differences were found between SDS of height and weight in healthy individuals and thalassaemic patients (P<0.01). SDS for height was -3.2 vs -0.89 and SDS for weight was -2.91 vs -1.16 for thalassaemic and healthy individuals, respectively. Furthermore, SDS for weight and SDS for height were positively correlated in both thalassaemic patients and healthy individuals. This correlation was stronger in thalassaemic patients (r=0.86). From another point of view, in those older than 14 years, there was a significant difference between height and weight of thalassaemic patients and healthy individuals (P<0.01). The prevalence of hypogonadism in this study was about 60%. The mean ages of puberty onset in thalassaemic and healthy boys were 16.5 ±1 and 11.6 ± 2 years and for girls were 16±3 and 10 ± 1 years, respectively (P<0.01). There was no difference in onset of puberty in 8 to 11 year-old thalassaemic patients in both good and poor control groups, whereas it was statistically significant in 12 to 14 years old patients of both groups (P<0.05). This study reveals a strong relationship between growth retardation and weight loss in thalassaemic patients, especially above the age of 14, as well as the role of poor control of plasma ferritin in puberty delay. It was also shown that, because of the equal prevalences of short stature and hypogonadism in thalassemic patients, hypogonadism can be an important factor in short stature of these patients.