A case of GH deficiency and beta-thalassemia

Minerva Endocrinol. 2012 Jun;37(2):201-9.

Abstract

A 23-year-old male patient, who suffers from beta-thalassemia major, came to us for an endocrine-metabolic evaluation. Medical history showed a diagnosis of heart disease with heart failure since the age of 16, type 1 diabetes mellitus diagnosed at the age of 18, treated with an intensive insulin therapy with a poor glycometabolic control. Patient performed regular blood transfusions and iron chelation with deferasirox. An echocardiogram revealed an enlarged left ventricle. Patient had undergone a comprehensive study of buoyancy both basal and hormone-stimulated and it was therefore carried out a diagnosis of GH deficiency and hypogonadotropic hypogonadism. A recombinant GH replacement therapy was then prescribed. After six months of therapy, the patient reported a net improvement of asthenic symptoms. Physical examination showed a reduction in abdominal adiposity in waist and an increase of 5 cm in stature. Laboratory tests showed an amelioration of glycometabolic control, such as to justify a reduction in daily insulin dose. The stature observed was thought appropriate to begin the administration of testosterone. Moreover, the cardiological framework showed a reduction of left ventricular dilatation, good ventricular motility, global minimum persistent tricuspid but not mitral regurgitation and no alteration on ECG.

Publication types

  • Case Reports

MeSH terms

  • Asthenia / etiology*
  • Blood Transfusion
  • Cardiovascular Agents / therapeutic use
  • Chelation Therapy
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / etiology*
  • Diabetes Mellitus, Type 1 / metabolism
  • Dwarfism / drug therapy
  • Dwarfism / etiology
  • Growth Hormone / therapeutic use
  • Heart Failure / drug therapy
  • Heart Failure / etiology*
  • Human Growth Hormone / deficiency*
  • Humans
  • Hypogonadism / complications*
  • Hypogonadism / diagnosis
  • Hypogonadism / drug therapy
  • Insulin / administration & dosage
  • Insulin / therapeutic use
  • Iron Chelating Agents / therapeutic use
  • Iron Overload / etiology*
  • Male
  • Mitral Valve Insufficiency / etiology
  • Testosterone / therapeutic use
  • Tricuspid Valve Insufficiency / etiology
  • Young Adult
  • beta-Thalassemia / complications*
  • beta-Thalassemia / drug therapy
  • beta-Thalassemia / therapy

Substances

  • Cardiovascular Agents
  • Insulin
  • Iron Chelating Agents
  • Human Growth Hormone
  • Testosterone
  • Growth Hormone