Iron deposition in the anterior pituitary in homozygous beta-thalassemia: MRI evaluation and correlation with gonadal function

Objective: Iron deposition in the anterior pituitary continues to pose a se rious problem in older patients with homozygous beta-thalassemia particular ly in terms of gonadal function. This study aimed to investigate whether ir on loading within the pituitary correlated with endocrine function. Patients: 33 patients above 15 years of age, with transfusion-dependent hom ozygous beta-thalassemia and iron overload were studied. All had been recei ving deferoxamine since 1978, Design and Measurements: The endocrine status of the patients was assessed on clinical examination by an endocrinologist, and by a gonadotropin releas ing hormone stimulation test. MRI of the pituitary was carried out for each patient. Results: Anterior pituitary function (GnRH stimulation test) correlated wel l with MRI results. However, no correlation was between the MRI measurement s, the stimulation test and the clinical status of the patients, as 28 out of the 33 patients achieved normal puberty. Conclusions: MRI in conjunction with a GnRH stimulation test may be useful in predicting future impairment of pituitary function; however, further stu dies are needed to assess the effect of chelation therapy on the iron overl oad in the gland.