Thyroid hormone profile in beta-thalassemia major children

Background: The commonest form of thyroid dysfunction, seen in thalassaemics, is subclinical hypothyroidism due to abnormalities of the thyroid gland which, leads to insufficient production of thyroid hormones. However, the frequency of hypothyroidism varies depending on the region, quality of management and treatment protocols. Aim: This study was conducted with the aim of investigating the frequency of hypothyroidism in children with beta-thalassemia major and to study its correlation with serum ferritin. Material and methods: A case-control study was carried out in the OPD, Medical College, Kolkata. It included 100 children with Beta-Thalassemia major as cases. Hundred age and gender matched healthy controls were also included in the study. Results: The weight and height of the cases lagged behind those of the control group. Compared to the control group, the mean level of thyroid hormones (both T3 and T4) and Hemoglobin levels were significantly reduced while those of TSH and Serum Ferritin were significantly increased. Out of 100 cases, 64 were euthyroid, 34 and 2% had subclinical and clinical hypothyroidism respectively. No case of secondary hypothyroidism was detected. Our results showed no association between Serum ferritin levels and the frequency of hypothyroidism among studied patients. Conclusion: Thyroid dysfunction in thalassemia may start early in life, hypothyroidism is not clinically observed in most thalassemia major patients. Therefore, thyroid function should be followed on regular basis when other iron over load associated complications occurs. Regular follow-up for early detection and timely treatment of such complications could improve the quality of life of these patients.

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“…There was no correlation between thyroid dysfunction and gender and age. Similar results have been documented by Gathwala et al [11].…”

Section: Discussionsupporting

confidence: 92%

Relation of elevated serum ferritin levels to hypothyroidism in children with beta-thalassemia major

et al. 2016

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“…In thyroid dysfunction, raised TSH level was observed in 24% of Thalassemia patients, which was reliable with diagnosis of subclinical hypothyroidism. Likewise, raised TSH level was the most frequent thyroid dysfunction in prior studies of Pirinccioglu et al, 7 Jaruratanasirikul et al, 8 Malik et al, 9 Hashemizadeh et al 10 and Gathwala et al 11 In this study, 2% of patients had lower T4 and higher TSH, reliable with the diagnosis of overt hypothyroidism. Once again, present study is equivalent to the study done by Solanki et al 12 Similarly many workers, such as Malik et al 9 (1.4%), Hashemizadeh et al 10 (1%), a small number of patients were also found overt hypothyroidism.…”

Section: Discussionsupporting

confidence: 66%

“…Thalassemia major is also known as Cooley's anaemia. Severe beta thalassemia is characterized by transfusion dependent anaemia, usually manifest in the first year of life (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) when HbF declines normally. They manifest as gradually increasing pallor, poor feeding, failure to thrive, irritability, fatigability, intermittent infections (Fever and diarrhoea), jaundice and develop hepatosplenomegaly.…”

mentioning

confidence: 99%

Study of Thyroid Profile in Beta Thalassemia Major Children of North Bihar and Its Correlation With Serum Ferritin Levels

Mishra¹

2019

jemds

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BACKGROUND Thalassemia major is an inherited disease, caused by abnormal hemoglobin synthesis that results from alteration in the rate of globin chain production. Blood transfusion in beta-thalassemia patient is essential for prolonging life. There may be an overload of iron with repeated blood transfusion and inadequate iron chelation therapy, which can lead to various endocrine complications such as hypothyroidism, cardiomyopathy, growth hormone deficiency, diabetes mellitus, hypoparathyroidism and hypogonadotropic gonadism. We wanted to study the incidence of Hypothyroidism in children with thalassemia major on regular blood transfusion and its correlation with serum ferritin levels that indicate iron overload in thalassemia patients. METHODS 50 children with beta-thalassemia major, who received regular blood transfusion therapy for at least two years and was selected with a ferritin level greater than 1000 μgm/ dl. Important history with clinical examination of each patient was recorded. Thyroid function tests and serum ferritin value were recorded from the patient's data and analysed. RESULTS 24% of patients were subclinical hypothyroidism and 2% had overt hypothyroidism. Incidence of hypothyroidism has no direct correlation with serum ferritin level in this study. CONCLUSIONS Hypothyroidism was seen in about 26% of children with thalassemia major in our study. Detecting hypothyroidism is important for patient because effective thyroid hormone replacement therapy is easy and possible. Therefore, thyroid function test should be monitored from time to time, especially when there are complications related to iron overload. With early identification and prevention of various endocrine complications it is possible to maintain the life of these children fairly comfortably and also increase the life expectancy.

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“…22,23 In the present study, compensated hypothyroidism (88.9%) was prevalent among the hypothyroid patients which was consistent with the studies done by Sharmin et al, Zervas et al, Farmaki and Agarwal et al [22][23][24][25] Uncompensated hypothyroidism was only 11.1% among the hypothyroid patients in the present study, which was similar to the study done by Gathwala et al as they found 12% uncompensated hypothyroidism. 26 In our study, all hypothyroid cases had ferritin level of ≥2000 ng/ml and a significant association between hypothyroidism and high ferritin level (≥2000 ng/ml) was found (p=0.028). This finding was consistent with the study done by Hantrakool as they suggested elevated serum ferritin level is a predictor of the development of hypothyroidism in thalassemia patients with iron overload and the maximum serum ferritin levels of greater than 3,500 μg/dl are associated with hypothyroidism in their study.…”

Section: Discussionsupporting

confidence: 51%

Assessment of thyroid function status in transfusion dependent thalassemic children

Mazumder¹,

Begum

Parvin

et al. 2022

Int J Contemp Pediatr

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Background: Frequent blood transfusions have been associated with serum iron overload, which may result in hypothyroidism and other endocrine abnormalities in transfusion dependent thalassemic patients. Thyroid dysfunction has been reported in a number of studies on these pts. The aim of the study is to assess the thyroid function status among the transfusion dependent thalassemic children.Methods: This was a cross sectional study conducted in the department of transfusion medicine, department of Pediatric hematology and oncology and department of hematology, Bangabandhu Sheikh Mujib medical university (BSMMU), Dhaka for a period of 18 months. A total number of 86 children with transfusion dependent thalassemia who met the inclusion and exclusion criteria were studied. Demographic data as well as history of blood transfusion and chelation therapy were collected. Thyroid function and iron load status were evaluated by measuring serum FT4, TSH and ferritin levels.Results: Out of 86 thalassemia patients, euthyroid patients were 77 (89.5%) and hypothyroid patients were 9 (10.5%). Eight (9.3%) patients were compensated and 1 (1.2%) was uncompensated hypothyroidism. Statistically significant association was found between number of blood transfusion and serum ferritin level (≥2000 ng/ml) with development of hypothyroidism in thalassemic patients. Mean ferritin level was higher in hypothyroid (4797.8±2027.4 ng/ml) group than in euthyroid (3628.8±2448.5 ng/ml) groups.Conclusions: Frequency of hypothyroidism was 10.5% (compensated 9.3% and uncompensated 1.2%). Number of blood transfusion and ferritin level were found significantly associated with the development of hypothyroidism in thalassemic patients.

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Thyroid hormone profile in beta-thalassemia major children

Abstract: Keywords: Thalassemia, Thyroid hormone; ChildrenOnline: 26 August 2009DOI: 10.3329/bmrcb.v35i2.2534Bangladesh Med Res Counc Bull 2009; 35: 70-71

Cited by 6 publications

References 8 publications

Relation of elevated serum ferritin levels to hypothyroidism in children with beta-thalassemia major

Relation of elevated serum ferritin levels to hypothyroidism in children with beta-thalassemia major

Study of Thyroid Profile in Beta Thalassemia Major Children of North Bihar and Its Correlation With Serum Ferritin Levels

Assessment of thyroid function status in transfusion dependent thalassemic children

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