ENDOCRINOPATHIES IN ADULT PATIENTS WITH TRANSFUSION-DEPENDENT THALASSEMIA IN HOSPITAL SULTANAH BAHIYAH

Abstract

INTRODUCTION
Thalassaemia is the most common hereditary haematological disorder in Malaysia. Patients with transfusion-dependent thalassaemia (TDT) treated with frequent blood transfusion are typically at risk for developing multiple complications like endocrinopathies. Our primary objective is to determine the screening rate of endocrinopathies among our TDT patients. We also aimed to determine the prevalence of endocrinopathies and factors correlated with endocrinopathies.

METHODOLOGY
This was a retrospective evaluation of all 113 patients with TDT who were under the care of the Haematology clinic, Hospital Sultanah Bahiyah with follow-up 6 months prior to data collection. Relevant data were retrieved from electronic medical records. Data collection was done in April 2023. Statistical analyses were performed using SPSS version 11.0.

RESULT
Median age of our cohort is 31 years (Interquartile range 18 years), and 50.4% of the patients were female. Majority of the patients (92%) received at least one endocrinopathy screening. The most commonly screened endocrinopathies were hypothyroidism (82%), followed by diabetes mellitus (66%) and hypoparathyroidism (53%). About 39% of our patients have at least one endocrine complication. Of these, 24% had one endocrinopathy, 11.5% had two endocrinopathies while 3.6% had 3 or more endocrinopathies. Growth failure (58%) was the most prevalent endocrinopathy among our cohort, followed by hypocortisolism (50%) and osteopenia (48%) while prevalence of hypothyroidism was 15%. There were
significant correlations between ferritin level and liver iron concentration (LIC) [p<0.01] and cardiac iron concentration (CIC) [p<0.01]. No significant correlation was found between ferritin level and the presence of endocrinopathies, or between LIC and CIC with the presence of endocrinopathies.

CONCLUSION
There was a low screening rate for endocrinopathies among our patients, particularly for osteoporosis, growth failure, hypocortisolism and hypogonadism. This audit shall serve to raise the awareness of healthcare practitioners to screen for endocrinopathies among patients with TDT.