IGF1 and anemia (phenotype): Soliman et al. have demonstrated the beneficial effect of correcting anemia on increasing serum levels of IGF-1 in children with TM.24,38 Similarly, correction of other forms of anemia and correction of hypoxia by surgical repair of congenital cyanotic heart lesions have been previously shown to improve IGF-1 secretion, as well as subsequent growth.39–41 In the study by Soliman et al., however, the TM patients were severely anaemic (7.5 ±1.2 g/dl) before blood transfusion.