Hauschild Michael, Theintz Gérald
Unité d'endocrinologie-diabétologie pédiatrique, Département médico-chirurgical de pédiatrie, CHUV, 1011 Lausanne.
Rev Med Suisse. 2007 Apr 18;3(107):988-91.
Hemolytic anemias can induce various anomalies of the endocrine glands which can already be observed in children. Endocrine dysfunction is also found in the course of therapy for aplastic anemias, usually as undesirable side effects. In Europe, 2-9% of the population belongs to ethnic minorities at risk for developing hemolytic anemia. Pituitary affinity to iron deposition explains the high incidence of hypogonadism, puberty delay and growth retardation although other factors have to be considered. Growth hormone deficiency has to be ruled out as it can occur in a minority of subjects with thalassemia and sickle-cell disease (drepanocytosis). Diabetes mellitus, hypothyroidism and hypoparathyroidism may also develop. Follow-up includes close monitoring of growth and pubertal development in order to guide therapeutic interventions.
溶血性贫血可诱发内分泌腺的各种异常,这在儿童中已可观察到。再生障碍性贫血治疗过程中也会出现内分泌功能障碍,通常是不良副作用。在欧洲,2%至9%的人口属于有患溶血性贫血风险的少数民族。垂体对铁沉积的亲和性解释了性腺功能减退、青春期延迟和生长发育迟缓的高发生率,不过还需考虑其他因素。必须排除生长激素缺乏症,因为少数地中海贫血和镰状细胞病(镰状细胞血症)患者可能会出现这种情况。糖尿病、甲状腺功能减退和甲状旁腺功能减退也可能发生。随访包括密切监测生长和青春期发育,以指导治疗干预。