SUMMARY One hundred and eight children presenting with Mycoplasma pneumoniae infection were assessed during the acute illness and followed for three years. The incidence of wheezing with the acute infection (40%) was greater than expected in a normal childhood population. The initial illness precipitated wheezing for the first time in some subjects but others wheezed only with the acute illness. In non-asthmatic subjects significant bronchodilator responsiveness was present one month after infection. Children given erythromycin during the first seven days of their illness had a significantly shorter fever duration compared with those treated inappropriately. No significant effects of treatment were noted on pulmonary function three years later but non-asthmatic children had abnormal mean forced expiratory volume in one second and forced expiratory flow after 50% of the expired vital capacity compared with 64 healthy controls. These findings indicate impaired function three years after initial infection.

SUMMARY Basal thyroid function was assessed from the serum thyroxine, triiodothyronine, and thyroid-stimulating hormone concentrations in 1 14 patients (mean age 13 * 6 years), designated group 1, with thalassaemia major. Forty of these patients were further evaluated (group 2) for serum-free thyroxine, and free and reverse triiodothyronine concentrations. The response of thyroid-stimulating hormone to thyrotrophin-releasing hormone was measured in 25 patients from this subgroup. Results were compared with those from 53 control subjects. Primary hypothyroidism, defined by a raised thyroid-stimulating hormone level above the upper range limit of 6 5 VdU/ml of the controls, was present in 17 5 % of the 114 patients. In group 2 patients, a spectrum of thyroid disease spanning uncompensated and compensated primary hypothyroidism and decreased thyroid reserve was evident. The presence of primary hypothyroidism (uncompensated and compensated) was associated with an age of at least 10 years, an increased incidence of iron toxicity-related systemic complications, and an increased transfusion iron load, but not with an increased serum ferritin level. In the total 114 patients there were 9 who had the low triiodothyronine (sick euthyroid) syndrome. Primary hypothyroidism occurs in a significant proportion of thalassaemia major patients in the absence of obvious clinical signs of hypothyroidism; the low triiodothyronine syndrome associated with non-thyroidal disease is not uncommon.

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