Document Detail


Exaggerated TSH response to TRH ("sub-biochemical" hypothyroidism) in prepubertal and adolescent thalassaemic patients with iron overload: prevalence and 20-year natural history.
MedLine Citation:
PMID:  19337173     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The severity of thyroid dysfunction in patients with beta-thalassaemia major is variable in different series. An exaggerated thyrotropin response to thyrotropin-releasing-hormone (TRH) has been found in 1 out of 5 beta-thalassaemia major patients. Because it is not well known how many of these patients will develop overt or subclinical hypothyroidism, we reviewed retrospectively the thyroid status (thyroid hormones, TBG, TG basal and TSH peak after TRH test) of 24 children and adolescents with beta-thalassemia major (mean age 12.1+/-3.9 years) on periodic transfusion therapy, regularly followed in our Centre during the last 20 years. As controls we studied 30 normal subjects aged 13.4+/-2.5 years. In our group of 24 thalassaemics an exaggerated TSH response to TRH test was found in 8 (33.3%), 3 of whom developed subclinical or overt hypothyroidism from 3 to 11 years later. TSH peak values correlated directly with ferritin levels, ALT, and compliance index to chelation therapy. Our data suggest that an exaggerated TSH response to TRH test is frequent in beta-thalassemia major, and may evolve into subclinical or overt hypothyroidism as we found in 37.5% of our patients with sub-biochemical hypothyroidism.
Authors:
Vincenzo De Sanctis; Rita Tanas; Maria Rita Gamberini; Monica Sprocati; Maria Rita Govoni; Maria Marsella
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric endocrinology reviews : PER     Volume:  6 Suppl 1     ISSN:  1565-4753     ISO Abbreviation:  Pediatr Endocrinol Rev     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2009-04-01     Completed Date:  2009-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101202124     Medline TA:  Pediatr Endocrinol Rev     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  170-3     Citation Subset:  IM    
Affiliation:
Department of Reproduction, Paediatric and Thalassaemia Unit, St. Anna Hospital, Ferrara, Italy. vdesanctis@libero.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Humans
Hypothyroidism / blood
Iron Overload / blood*
Retrospective Studies
Statistics, Nonparametric
Thyroglobulin / blood
Thyrotropin / blood*
Thyrotropin-Releasing Hormone / pharmacology*
Thyroxine / blood
Triiodothyronine / blood
beta-Thalassemia / blood*
Chemical
Reg. No./Substance:
24305-27-9/Thyrotropin-Releasing Hormone; 6893-02-3/Triiodothyronine; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin; 9010-34-8/Thyroglobulin

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