Skip to main content
SpringerLink
Log in

Pubertal Development and its Determinants in Adolescents With Transfusion-Dependent Thalassemia

  • Research Paper
  • Published:
Indian Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To assess pubertal development and its determinants in adolescents with transfusion-dependent thalassemia (TDT).

Methods

In this cross-sectional study from a tertiary teaching hospital in Delhi, records of adolescents aged 17–19 years with TDT on regular transfusion at thalassemia day-care centre were reviewed. Pubertal development and its determinants were assessed.

Results

Records of 58 (33 male) adolescents with TDT were reviewed. Among them, 42 (72.4%) had normal/delayed onset with spontaneous progression of puberty, while 16 (27.6%) had pubertal arrest/failure and received hormonal replacement therapy (HRT). Short stature was observed in all adolescents on HRT. Amongst other endocrinopathies, only hypoparathyroidism was found to be significantly higher in the HRT group. On multivariate analysis, serum ferritin (OR-1.005, 95% CI 1.002, 1.009) was observed to be the only significant determinant of pubertal arrest/failure.

Conclusion

A significant proportion of adolescents with TDT continue to have pubertal arrest/failure. High systemic iron load is the key determinant for this.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Toumba M, Sergis A, Kanaris C, Skordis N. Endocrine complications in patients with thalassaemia major. Pediatr Endocrinol Rev. 2007;5:642–8.

    PubMed  Google Scholar 

  2. Raiola G, Galati MC, De Sanctis V. Growth and puberty in thalassemia major. J Pediatr Endocrinol Metab. 2003;16: 259–66.

    PubMed  Google Scholar 

  3. Delvecchio M, Cavallo L. Growth and endocrine function in thalassemia major in childhood and adolescence. J Endocrinol Invest. 2010;33:61–8.

    Article  CAS  Google Scholar 

  4. Sharma R, Seth A, Chandra J, et al. Endocrinopathies in adolescents with thalassaemia major receiving oral iron chelation therapy. Paediatr Int Child Health. 2016;36:22–7.

    Article  Google Scholar 

  5. Indian Academy of Pediatrics Growth Charts Committee, Khadilkar V, Yadav S, Agrawal KK, et al. Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children. Indian Pediatr. 2015;52: 47–55.

    Article  Google Scholar 

  6. Al-Akhras A, Badr M, El-Safy U, et al. Impact of genotype on endocrinal complications in b-thalassemia patients. Biomed Rep. 2016;4:728–36.

    Article  CAS  Google Scholar 

  7. De Sanctis V, Soliman AT, Elsedfy H, et al. Growth and endocrine disorders in thalassemia: The international network on endocrine complications in thalassemia (I-CET) position statement and guidelines. Indian J Endocrinol Metab. 2013;17:8–18.

    Article  Google Scholar 

  8. Pattanashetti MA, Pilli GS. Assessment of growth parameters in transfusion dependent thalassemics at a tertiary care hospital. Annals of Pathology and Laboratory Medicine. 2018;5:316–21.

    Article  Google Scholar 

  9. Soliman AT, El Zalabany MM, Amer M, Ansari BM. Growth and pubertal development in transfusion- dependent children and adolescents with thalassaemia major. Hemoglobin. 2009;33:16–20.

    Article  Google Scholar 

  10. Chatterjee R, Bajoria R. Critical appraisal of growth retardation and pubertal disturbances in thalassemia. Ann N Y Acad Sci. 2010;1202:100–14.

    Article  CAS  Google Scholar 

  11. Mousa AA, Ghonem M, Elhadidy el HM, et al. Iron overload detection using pituitary and hepatic MRI in thalassemic patients having short stature and hypogonadism. Endocr Res. 2016;41:81–8.

    Article  CAS  Google Scholar 

  12. Chatterjee R, Mukhopadhyay TN, Chandra S, Bajoria R. Sex steroid priming for induction of puberty in thalassemia patients with pulsatile reversible hypogonadotrophic hypogonadism. Hemoglobin. 2011;35:659–64.

    Article  CAS  Google Scholar 

  13. De Sanctis V, Eleftheriou A, Malaventura C. Thalassaemia International Federation Study Group on Growth and Endocrine complications in thalassaemia. Prevalence of endocrine complications and short stature in patients with thalassaemia major: A multicenter study by the Thalassaemia International Federation (TIF). Pediatr Endocrinol Rev. 2004;2:249–55.

    PubMed  Google Scholar 

  14. Albu A, Barbu CG, Antonie L, Vladareanu F, Fica S. Risk factors associated with hypogonadism in â-thalassemia major patients: Predictors for a frequent complication of a rare disease. Postgrad Med. 2014;126:121–7.

    Article  Google Scholar 

  15. Belhoul KM, Bakir ML, Saned M-S, Kadhim AMA, Musallam KM, Taher AT. Serum ferritin levels and endocrinopathy in medically treated patients with â thalassemia major. Ann Hematol. 2012;91:1107–14.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Lady Hardinge Medical College and Kalawati Saran Children’s Hospital, New Delhi, 110 001, India

    Preeti Singh, Sukla Samaddar, Nupur Parakh, Jagdish Chandra & Anju Seth

Authors
  1. Preeti Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sukla Samaddar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nupur Parakh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jagdish Chandra
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anju Seth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anju Seth.

Additional information

Ethics Clearance

Institutional Ethical Committee for Human Research, Lady Hardinge Medical College and associated hospitals; No. LHMC/ECHR/2018/29, dated 10 May, 2018.

Contributors

PS: planning, execution of the study, data analysis and writing the manuscript; SS: data compilation, data analysis and writing the manuscript; NP,JC: execution of the study and writing the manuscript; AS: planning, execution of the study, data analysis and writing the manuscript. All authors approved the final version of manuscript.

Funding

None

Competing interests

None stated.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Singh, P., Samaddar, S., Parakh, N. et al. Pubertal Development and its Determinants in Adolescents With Transfusion-Dependent Thalassemia. Indian Pediatr 58, 635–638 (2021). https://doi.org/10.1007/s13312-021-2258-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13312-021-2258-7

Keywords

Search

Navigation