An ICET-A survey on occult and emerging endocrine complications in patients with β-thalassemia major: Conclusions and recommendations

Vincenzo De Sanctis*, Ashraf T. Soliman, Duran Canatan, Ploutarchos Tzoulis, Shahina Daar, Salvatore Di Maio, Heba Elsedfy, Mohamed A. Yassin, Aldo Filosa, Nada Soliman, Mehran Karimi, Forough Saki, Praveen Sobti, Shruti Kakkar, Soteroula Christou, Alice Albu, Constantinos Christodoulides, Yurdanur Kilinc, Soad Al Jaouni, Doaa KhaterSaif A. Alyaarubi, Su Han Lum, Saveria Campisi, Salvatore Anastasi, Maria Concetta Galati, Giuseppe Raiola, Yasser Wali, Ihab Z. Elhakim, Demetris Mariannis, Vassilis Ladis, Christos Kattamis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


In adult thalassemia major (TM) patients, a number of occult and emerging endocrine complications, such as: central hypothyroidism (CH), thyroid cancer, latent hypocortisolism, and growth hormone deficiency (GHD) have emerged and been reported. As the early detection of these complications is essential for appropriate treatment and follow-up, the International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescent Medicine (ICET-A) promoted a survey on these complications in adult TM patients, among physicians (pediatricians, hematologists and endocrinologists) caring for TM patients in different countries. The data reported by 15 countries are presented.The commonest endocrine complications registered in 3.114 TM adults are CH and GHD (4.6 % and 3.0 %, respectively), followed by latent hypocortisolism (1.2%). In 13 patients (0.41%) a cytological papillary or follicular thyroid carcinoma was diagnosed in 11 and 2 patients, respectively, and a lobectomy or thyroidectomy was carried out. Of 202 TM patients below the age of 18 years, the reported endocrine complications were: GHD in 4.5%, latent hypocortisolism in 4.4% and central hypothyrodisim in 0.5%. Transition phase was an area of interest for many clinicians, especially as patients with complex chronic health conditions are responding to new treatments extending their lifespan beyond imagination.. In conclusion, our survey provides a better understanding of physicians’ current clinical practices and beliefs in the detection, prevention and treatment of some endocrine complications prevailing in adult TM patients. Regular surveillance, early diagnosis, treatment and follow-up in a multi-disciplinary specialized setting are recommended. (

Original languageEnglish
Pages (from-to)481-489
Number of pages9
JournalActa Biomedica
Issue number4
Publication statusPublished - Jan 17 2018


  • Central hypothyroidism
  • Growth hormone deficienctransition phase
  • ICET-A
  • Latent hypocortisolism
  • Thalassemia major

ASJC Scopus subject areas

  • Medicine(all)


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