Department of Paediatrics, University College Hospital, London, WC1 E6AU, and Department of Paediatrics, Whittington Hospital, London, N19 5JG
(Received 4 July 1975)
Iron deposition in thalassaemia major is the sequel to intravenous loading of iron with blood transfusion therapy and to increased iron absorption via the gastrointestinal tract (Erlandson, Walden, Stern, Hilgartner, Wehman & Smith, 1962). Iron deposition in the reticuloendothelial system, heart and endocrine organs causes clinical problems usually in the second decade of life. The threshold adrenal stimulation test of Landon, James, Wharton & Friedman (1967) was designed to show minor adrenocortical dysfunction at the physiological level. This useful but lengthy test has many difficulties in paediatrics requiring pituitary suppression and an intravenous drip. Its main limitation, however, has been the absence of published normal paediatric values, these being ethically very difficult to collect.
Table 1. Threshold adrenocortical stimulation test. Increase in plasma cortisol concentration (μg/100 ml) above
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