Endocrine Manifestations in Children and Adolescents with Thalassemia Major - A Prospective Cohort Study
Bibliographic record
Abstract
Background: Thalassemia major is a widely prevalent genetic hemoglobinopathy marked by inadequate erythropoiesis and persistent hemolytic anemia. Although frequent blood transfusions are life-saving, such therapy leads to accumulated iron excess, which impacts multiple organs, including the endocrine glands. Despite progress in iron chelation therapy, endocrinopathies continue to be a considerable source of morbidity in individuals with thalassemia major. Objective: This article explores the endocrine manifestations in children and adolescents with thalassemia major and identifies associated risk factors. Methods: This study included 51 children and adolescents with a thalassemia major attending the clinic. The researchers recorded a detailed history of each participant, made an anthropometric assessment, and conducted a clinical examination. Furthermore, laboratory investigations were performed to measure each participant's complete blood count, serum ferritin, glucose parameters (FBS, PPBS, HbA1c), thyroid function (T3, T4, TSH), serum calcium, and gonadotropin levels (LH, FSH) in children >13 years of age. Results: Within the study population, 74.5% had initiated transfusions before one year of age, and 88.2% received monthly transfusions. Growth retardation was evident, with 23.5% and 29.4% having weight and height, respectively, below the third centile. Endocrine abnormalities included diabetes (25.5%), hypothyroidism (9.8%), hypogonadotropic hypogonadism (25% with low LH and 12.5% with low FSH) in children >13 years of age (n=8), and hypocalcemia (21.6%). Serum ferritin was elevated (> 1500 ng/mL) in 90.2% of patients. Significant associations were observed between HbA1c levels and chelation therapy (p < 0.001), as well as hypogonadism and chelation therapy (p = 0.005). Multiple endocrinopathies (> 2) were observed in 11.7% of patients. Conclusion: Endocrine complications are common in pediatric thalassemia major patients, and glucose metabolism abnormalities are the most prevalent. Age, transfusion burden, and chelation therapy significantly influence the risk of endocrinopathies. Regular monitoring of endocrine function and appropriate interventions are essential for improving the quality of life and reducing morbidity in these patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".