Thyroid hormone profile in beta-thalassemia major children

Iranian journal of pediatrics, 2011

Hypothyroidism usually appears in the second decade of life and is thought to be associated with iron overload in patients with thalassemia major. This study aimed to evaluate thyroid dysfunctions in patients with beta-thalassemia major and to see if they appear in the earlier period of life. Thyroid function and iron load status were evaluated in 90 children with a mean age of 7.17±3.78 years with beta-thalassemia major by measuring serum free thyroxin (FT4), serum free triiodothyronine (FT3), total thyroxin (T3), serum total triiodothyronine (T4), thyroid-stimulating hormone (TSH) and ferritin levels from serum of patients admitted to the Pediatric Department, Faculty of Medicine University of Dicle between March 2005 and July 2009. A control group formed from an age-sex matched healthy children with a mean age of 6.98±3.66 years was also included. A standard thyrotropin releasing hormone test was applied to 3 patients who had high TSH levels and were classified as subclinical pri...

Iranian journal of pediatric hematology and oncology, 2012

Background Hypothyroidism usually appears in the second decade of life and is thought to be associated with iron overload in patients with thalassemia major. This study aimed to evaluate thyroid dysfunctions in patients with beta-thalassemia major. Materials and Methods This research is a descriptive – cross sectional study, carried out in 2009 to assess thyroid function in 100 patients with beta thalassemia major at the ages between 2-18 years. The study was carried out retrospectively and 100 medical records from 400 samples of thalassemia major patients, under regular care of Sarvar Clinic, were assessed. Thyroid function and iron load status were evaluated by measuring the serum total triiodothyronine (T4), thyroidstimulating hormone (TSH) and ferritin levels from the serum of patients, admitted to the Sarvar Clinic. TSH and T4 concentrations were estimated by enzyme-linked immunosorbent assay (ELISA). Primary hypothyroidism was defined by a TSH level >4μIU/ml. Results were a...

International journal of scientific research, 2020

International Journal of Pediatrics

Background. Thalassemia is the most common genetic disorder worldwide. Use of iron chelators has improved survival but endocrine complications have become more frequent. The frequency of hypothyroidism in Beta Thalassemia Major (BTM) children ranges from 6 to 30 %. Thyroid dysfunction mainly occurs by gland infiltration, chronic tissue hypoxia, free radical injury, and organ siderosis. Objectives. (a) To evaluate the thyroid function status in chronically transfused children with BTM, in the first and second decade of life and (b) to study the influence of factors like duration and amount of blood transfusions, serum ferritin level, and iron chelation therapy on thyroid function. Methodology. BTM children, 3 years old and above, on regular blood transfusions with serum ferritin > 1500 mcg/l were included in the study. Thyroid function and ferritin assessment was done using ELISA kits. Autoimmune thyroiditis was ruled out by antithyroid peroxidase and antithyroglobulin antibody te...

Indian Journal of Child Health, 2021

Objective: The objective of the study was to determine the hospital-based prevalence of thyroid dysfunction in transfusion-dependent beta-thalassemia in children and to study the correlation between serum ferritin levels and thyroid functions. Methods: This prospective cross-sectional study in transfusion-dependent thalassemia patients was conducted in the department of pediatrics of a teaching hospital in India. General and systemic examinations were done and recorded and hemoglobin (Hb)%, thyroid-stimulating hormone (TSH), T3, T4, free thyroxin 4 (FT4), serum ferritin, and anti-thyroid peroxidase (TPO) levels were estimated in the laboratory. Initially, the estimation of Hb, TSH, T3, T4, and serum ferritin was done for all the study participants. Later, the specific values of FT4 and anti-TPO were estimated in study participants with high TSH values. Results: Fifty beta-thalassemia children aged between 3 and 18 years were chosen in this study. The prevalence of subclinical hypothyroidism was 6% and no cases of clinical or central hypothyroidism were found. The mean serum ferritin level was 2671 ± 1592 ng/ml; however, no positive correlation between serum ferritin and TSH values was seen. Conclusion: In thalassemia patients, the thyroid failure usually occurs by the second decade of their life. It is important that all beta-thalassemia children should undergo annual screening of thyroid functions in addition to detection of their serum ferritin levels.

Pakistan Journal of Medical and Health Sciences

Objective: To determine the prevalence of hypothyroidism among children with β-thalassemia major. Study Design: Cross-sectional study. Place and Duration of the Study: The Department of Hematological Disorder, Thalassemia and Bone Marrow Transplantation Centre, and Department of Biochemistry, Bahawal-Victoria Hospital, Quaid e Azam Medical College”, Bahawalpur, Pakistan from 1st January 2021 to 31st December 2021. Methodology: A total of 125 children of both genders (2 to 18 years) with diagnosis of β-thalassemia major were analyzed. Two ml blood sample under strict aseptic conditions was obtained from every study participant and sent to Institutional Pathological Laboratory for thyroid-stimulating hormone (TSH), T3, and T4. Results: In a total of 125 children with β-thalassemia major, 78 (62.4%) were male. Overall, mean age was 8.57±4.75 years while 57 (45.6%) children were aged between 6 to 10 years. Residential status of 84 (67.2%) children was rural. Parental consanguineous marr...

2019

Objective: To determine the status of thyroid function among β-thalassemia major patients dependent on transfusion.

Indian Journal of Endocrinology and Metabolism, 2013

Introduction: Primary hypothyroidism is one of the most frequent complications observed in-patients suffering from thalassemia. We investigated and reviewed the thyroid function in all thalassemic patients attending the Pediatric Endocrine Clinic of Hamad Medical Center, Doha, Qatar during the last 10 years of follow-up. Patients and Methods: A total of 48 patients with ß-thalassemia major between 5 years and 18 years of age. Thyroid dysfunction was defi ned as follows: Overt hypothyroidism (low Free thyroxine [FT4] and increased thyroid-stimulating hormone [TSH] levels >5 U/ml); subclinical hypothyroidism (normal FT4, TSH between 5 IU/ml and 10 IU/ml) and central (secondary) hypothyroidism (low FT4 and normal or decreased TSH). Results: A total of 48 patients (22 males and 26 females) completed a 12 year-period of follow-up. During this period, hypothyroidism was diagnosed in 17/48 (35%) of patients. There was no signifi cant difference in the prevalence in males 7/22 (32%) versus females 10/26 (38%). Sixteen of the patients had hypothyroidism after the age of 10 years (94%). The prevalence of overt hypothyroidism had risen from 0% at the age of 7 years to 35% at the age of 18 years. None of the patients had high anti-thyroperoxidase antibody titers. Out of 17 patients, 13 patients with hypothyroidism had normal or low TSH level (not appropriately elevated) indicative of defective hypothalamic pituitary response to low FT4 (central hypothyroidism). Three patients (6.3%) had subclinical hypothyroidism (TSH between 5 uIU/ml and 10 uIU/ml and normal FT4). The general trend of FT4 level showed progressive decrease over the 12 years, whereas, TSH levels did not show a corresponding increase. These data suggested defective hypothalamic pituitary thyroid axis involving both TSH and FT4 sretion in patients with thalassemia major over time. There was a signifi cant negative correlation between serum ferritin and FT4 (r = −0.39, P = 0.007), but no correlation was found between ferritin and TSH. Conclusions: Worsening of thyroid function was observed in 35% of the studied thalassemic patients by the age of 18 years. The lack of proper increase of TSH in response to the low circulating levels of FT4 in 13/17 (76%) of these patients indicates a relatively high incidence of defective pituitary thyrotrophic function in these patients.

Journal of Shaheed Suhrawardy Medical College, 2013

Background: Thalassaemia is a heterogeneous group of disorders. In multi-transfused thalassaemia major patients the thyroid gland function has been reported to be normal, decreased reserve, or primary hypothyroidism. Objective: This study was an attempt to know the thyroid function status in multi-transfused thalassaemic patients and it's correlation with iron overload. Methods: This cross sectional study was carried out in the Department of Pediatrics at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Transfusion centre of Bangladesh Thalassaemia Samity, Dhaka during May 2011 to April 2012. Previously diagnosed cases of thalassaemia major patients with transfusion dependent at any age with both sexes were randomly selected for this study. Serum total thyroxine (T4), total triiodothyronine (T3), thyroid stimulating hormone (TSH) and serum ferritin level were estimated from venous blood. Results: A total of 50 previously diagnosed cases of thalassaemia major patients of which 30 male and 20 female of 4 to 15 years age, transfusion dependent were randomly selected for this study. Hypothyroidism was present in 10(20%) patients. Among these 10 patients compensated primary hypothyroidism was in 5(10%) cases and decompensate primary hypothyroidism was 5(10%) cases. The TSH value of hypothyroid patients was higher. Serum ferritin value was significantly higher in all the three groups of thalassaemic patients. There was no significant correlation between the high serum ferritin value with thyroid stimulating hormone or serum total thyroxin level. Conclusion: All transfusion dependent thalassaemic patients need periodic evaluation of thyroid function because there was incidence of hypothyroidism. [

IOSR Journals , 2019

Background: aim of this study was to determine the proportion and type of hypothyroidism in patients with β-thalassemia major. Methods: This study was conducted in department of Pediatrics, Sir Padampat Mother & Child Health Institute, SMS medical college, Jaipur. It was a Hospital based cross sectional study for a period of 12 months from April 2015 to march 2016. Cases with confirmed diagnosis of β-thalassemia major that were on regular blood transfusions and 3 to 18 years of age (both sexes) and free from any other chronic diseases were included. Patients were subjected to a detailed history and physical examination. Blood samples for hemogram, serum ferritin level, S. Free T 4 , T 3 and TSH level, Anti-TPO Antibody levels were taken. Results: The study included 90 children of both sexes with thalassemia major within age-group 3-18 years. Out of these 69 (76.67%) were male and 21 (23.33%) female. Male to female ratio was 3.3:1.The mean age for the male patients was 9.07±4.02 years and for female patients, it was 9.09±3.45 years. Thyroid function tests were normal in 76 (84.44%) patients and rest 14 (15.56%) had abnormal thyroid function tests. Out of these 14 patients, 9 (10%) patients had subclinical hypothyroidism while 5 (5.56%) patients had central hyperthyroidism. No case with overt hypothyroidism and primary hypothyroidism was present. Subclinical hypothyroidism was most prevalent in the age group of 6-8 years (44.45%) while central hypothyroidism was most prevalent in the age group of >12 years (80%). Age of diagnosis of thalassemia for patients with normal thyroid function was 16.01+11.37 months; for subclinical hypothyroidism was 13.44+9.56 months; and for central hypothyroidism was 15.80+7.65 months. No significant correlation was found between the age of the diagnosis of the thalassemia and the thyroid dysfunctions of the subjects. (p>0.05). The mean value of serum ferritin in euthyroid patients was 2029.80+1163.38 ng/mL; for subclinical hypothyroidism was 2477.33+1062.95 ng/mL; for central hypothyroidism was 2914.00+930.54 ng/mL. No significant correlation was found between thyroid dysfunctions and the serum ferritin levels of the subjects (p>0.05). No significant correlation was found in thyroid dysfunctions in the study subjects and Anti-TPO antibody status of the subjects. The mean number of blood transfusions in euthyroid patient was 113.74 + 73.13; for subclinical hypothyroid was 123.78+81.11; for central hypothyroid was 208.60+41.90. Statistically significant correlation was found between thyroid dysfunctions and number of blood transfusions in subclinical and central hypothyroidism (p<0.05). www.iosrjournals.org 6 | Page Conclusions: Subclinical hypothyroidism is common endocrinal complication in thalassemia patients. We should be more vigilant in screening patients for subclinical hypothyroidism so that treatment could be started at an earlier stage. Hypothyroidism was not correlated with serum ferritin level of the patients but it was related with the number of blood transfusions. So patients might have hypothyroidism despite of controlled serum ferritin level and proper chelation therapy.