CORRELATION BETWEEN SERUM FERRITIN, TRANSFERRIN SATURATION AND PITUITARY MRI T2 RELAXATION TIMES AND FSH, LH AND TESTOSTERONE LEVELS IN MALE TRANSFUSION-DEPENDENT THALASSEMIA PATIENTS

DIAN ANINDITA LUBIS; E. M. YUNIR; RAHMAD MULYADI; ANNA MIRA LUBIS; SUKAMTO KOESNOE

doi:10.22159/ijap.2020.v12s3.39464

Authors

DIAN ANINDITA LUBIS Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
E. M. YUNIR Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
RAHMAD MULYADI Department of Radiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
ANNA MIRA LUBIS Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
SUKAMTO KOESNOE Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.22159/ijap.2020.v12s3.39464

Keywords:

Hypogonadism, Pituitary MRI T2 relaxation time, Transfusion-dependent thalassemia

Abstract

Objective: The purpose of this study is to see the correlation between iron overload with the hypogonadal state by analyzing the correlation between ferritin serum, transferrin saturation and pituitary MRI T2 relaxation time with FSH, LH and testosterone levels.

Methods: This is a cross-sectional study of 32 male subjects with transfusion-dependent thalassemia. The subjects were collected with a consecutive sampling technique in the thalassemia outpatient clinic in National Hospital in Indonesia. Measurements of serum ferritin, transferrin saturation, FSH, LH and testosterone were taken using ELISA technique. Pituitary MRI T2 relaxation time was done using MRI Avanto 1.5 Tesla.

Results: In this study, secondary sexual characteristics were not fully achieved in 62.5% of patients. Low testosterone levels were found in 25% of patients. There was a negative correlation between transferrin saturation and pituitary MRI T2 relaxation time in the normal testosterone level group.

Conclusion: This study showed a high rate of patients who had not achieve puberty, but a low rate of patients with low testosterone, which means there is a weak negative correlation between transferrin saturation and pituitary MRI T2 relaxation times.

Downloads

Download data is not yet available.

References

Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prevalence of hypogonadism in males aged at least 45 y: the HIM study. Int J Clin Pract 2006;60:762–9.

Dandona P, Rosenberg MT. A practical guide to male hypogonadism in the primary care setting. Int J Clin Pract 2010;64:682–96.

Seftel A. Male hypogonadism. Part II: Etiology, pathophysiology, and diagnosis. Int J Impot Res 2006;18:223–8.

Taher AT, Musallam KM, Inati A. Iron overload: consequences, assessment, and monitoring. Hemoglobin 2009;33:S46–57.

Srisukh S, Ongphiphadhanakul B, Bunnag P. Hypogonadism in major thalassemia patients. J Clin Transl Endocrinol 2016;5:42–5.

Galanello R, Origa R. Beta-thalassemia. Orphanet J Rare Dis 2010;5:11.

Shalitin S, Carmi D, Weintrob N, Phillip M, Miskin H, Kornreich L, et al. Serum ferritin level as a predictor of impaired growth and puberty in major thalassemia patients. Eur J Haematol 2005;74:93–100.

Kohgo Y, Ikuta K, Ohtake T, Torimoto Y, Kato J. Body iron metabolism and pathophysiology of iron overload. Int J Hematol 2008;88:7–15.

Hantrakool S, Tantiworawit A, Rattarittamrong E, Chai-Adisaksopha C, Nawarawong W, Srichairattanakool S, et al. Elevated serum ferritin levels are highly associated with diabetes mellitus and hypothyroidism in thalassemia patients. Blood 2012;120:5174.

Azarkeivan A, Hashemieh M, Shirkavand A, Sheibani K. Correlation between heart, liver and pancreas hemosiderosis measured by mri t2* among thalassemia major patients from Iran. Arch Iran Med 2016;19:96–100.

Wood JC. Magnetic resonance imaging measurement of iron overload. Curr Opin Hematol 2007;14:183–90.

Bozdag M, Bayraktaroglu S, Aydınok Y, Çallı MC. MRI assessment of pituitary iron accumulation by using pituitary-R2 in β-thalassemia patients. Acta Radiol 2017;59:732–9.

Abo-Elwafa HA, Hamid SA, Heshmat MM, Ahmed ZS. Impact of ferritin load on gonadal reserve among regular transfused β-thalassemia. OJBD 2017;7:65–78.

Habeb AM, Al-Hawsawi ZM, Morsy MM, Al-Harbi AM, Osilan AS, Al-Magamsi MS, et al. Endocrinopathies in beta-thalassemia major. Prevalence, risk factors, and age at diagnosis in Northwest Saudi Arabia. Saudi Med J 2013;34:67–73.

Wei C, Davis N, Honour J, Crowne E. The investigation of children and adolescents with abnormalities of pubertal timing. Ann Clin Biochem 2017;54:20–32.

Das N, Kumar TR. Molecular regulation of follicle-stimulating hormone synthesis, secretion and action. J Mol Endocrinol 2018;60:R131–R155.

De Sanctis V, Soliman AT, Yassin MA, Di Maio S, Daar S, Elsedfy H, et al. Hypogonadism in male thalassemia major patients: pathophysiology, diagnosis and treatment. Acta Biomed 2018;89:6–15.

Chatterjee R, Katz M. Reversible hypogonadotrophic hypogonadism in sexually infantile male thalassaemic patients with transfusional iron overload. Clin Endocrinol (Oxf) 2000;53:33–42.

Noetzli LJ, Panigraphy A, Mittelman SD, Hyderi A, Dongelyan A, Coates TD, et al. Pituitary iron and volume predict hypogonadism in transfusional iron overload. Am J Hematol 2012;87:167–71.