Dear Sir

I read the recent article[1] from Dr Eissa and Dr Tuck with great interest and I thank them for their comprehensive review.

The article states, ‘Individuals with β-thalassaemia major who are able to survive childhood by virtue of the availability of regular and frequent (usually monthly) blood transfusions, frequently acquire the organ damage caused by haemosiderosis, which results from the deposition of the excess iron derived from the breakdown of the donor erythrocytes received’.[1] In patients with sickle cell disease haemosiderosis is again thought to be the main cause of endocrine dysfunction. However, there is also a view that patients with sickle cell disease are prone to endocrine pathology due to sickle cell crises in the endocrine glands in the absence of iron overload.[2, 3]

I would welcome the authors’ understanding on the current view with regard to the aetiology of endocrine dysfunction in patients with sickle cell disease.


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