The impairment of the hypothalamic-pituitary axes in patients with thalassemia major is not dependent from the therapeutical management

The aim of the present study was to compare the functioning of the of the hypothalamic-pituitary axes between two groups of thalassemic patients treated since infancy with an advanced therapy (n = 7) or with irregular transfusion (n = 12). A group of control healthy children was also studied (n = 11). In all subjects were evaluated: 1) basal plasma levels of the hormones of the pituitary-gonadal, -adrenal, -thyroid and GH-somatomedin axis; 2) the GnRH-induced LH and FSH release; 3) the TRH-induced TSH and PRL release; 4) L-dopa-induced GH release. Basal plasma pituitary-gonadal axis hormone and somatomedin levels in thalassemics were lower than in controls, without differences between the regularly and irregularly treated. The gonadotropin response to the GnRH test, the PRL response to TRH test and the L-dopa-induced GH increase in both groups of thalassemics were lower than in controls but did not differ between the regularly and irregularly treated thalassemic patients. A TSH hyperesponsiveness to the TRH test was observed in some patients. These results confirmed that endocrine function in thalassemic patients is impaired and showed that the functioning of the various hypothalamic-pituitary axes in thalassemia major in not improved following regular therapeutical protocols.