Endocrinopathies in transfusion-associated iron overload.
BACKGROUND
Transfusional iron overload primarily results in reticuloendothelial iron accumulation, which is considered to be less harmful than parenchymal iron accumulation. However, systematic and comprehensive data on endocrine function in transfusion-associated haemochromatosis are limited.


METHODS
We examined 25 aplastic anaemia patients (11 men and 14 women) diagnosed with transfusion-associated haemochromatosis at a single institution. Pituitary function was determined with a combined pituitary function test. On a different day, a 75-g oral glucose tolerance test was performed. The bone mineral density (BMD) of the lumbar spine and total hip was assessed with dual-energy X-ray absorptiometry.


RESULTS
Twenty-two (88%) of these 25 patients had at least one endocrine abnormality, and 12 had more than one abnormality. The most common pituitary hormonal deficiency involved the pituitary-gonadal axis; 54% of the total subjects had hypogonadotropic hypogonadism. Two patients had an insufficient cortisol response to corticotrophin-releasing hormone stimulation. No patient had a deficiency of growth hormone or thyroid-stimulating hormone. Twelve (48%) had diabetes mellitus, and these patients tended to have higher concentrations of ferritin, alanine aminotransferase and γ-glutamyl transferase. Osteoporosis (T-score <-2·5 SD) was observed in 48% of patients. The reduction in BMD was more pronounced in the lumbar spine than in the total hip. The patients with osteoporosis were accompanied by hypogonadism, which predominantly affected the trabecular bone.


CONCLUSIONS
Our observations suggest that endocrinopathies are common in transfusion-associated haemochromatosis.
Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Mee Kyoung
MK
Kim
Jong Wook
JW
Lee
Ki Hyun
KH
Baek
Ki Ho
KH
Song
Hyuk Sang
HS
Kwon
Ki Won
KW
Oh
Eun Hee
EH
Jang
Moo Il
MI
Kang
Kwang Woo
KW
Lee
D000328:Adult; D001786:Blood Glucose; D005260:Female; D006706:Homeostasis; D006801:Humans; D019190:Iron Overload / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis; D010900:Pituitary Diseases / Q000209:etiology; D065227:Transfusion Reaction; D055815:Young Adult
D001786:Blood Glucose