Anaemia in hypothyroidism

Atm Atikur Rahman,Masuda Begum,Md Farid Uddin,Md Jalilur Rahman,Md Salahuddin Shah,Mossammat Diluba Akter

doi:10.3329/bmrcb.v46i1.47470

Abstract

Background: Anaemia is very common in hypothyroid patient. The results of the type of anaemia in hypothyroid patient studied outside may not be similar on Bangladeshi population. So far, there is no such study regarding the types of anaemia in hypothyroid patients in Bangladeshi population. Methods: This was a cross sectional study in patients with hypothyroidism who was attending in the thyroid and endocrine clinic of Bangabandhu Sheikh Mujib Medical University, Dhaka over a period of one year. All newly diagnosed cases were selected considering inclusion and exclusion criteria. A structured questionnaire was used for data collection. Results: Fifty newly detected hypothy sroid patients were studied among the study population, 52.0% was between 05 to 35 years and another 48.0% were in 36 to 65 years. 76.0% were female. Bradycardia was found in 20.0% cases. Puffiness of face, peripheral oedema and cold intoleran ce were found in 78.0%, 68.0% and 82.0% cases respectively. Hoarseness of voice, delayed relaxation of tendon reflexes and paraesthesia were found in about 80.0% cases. Myxoedema and vitiligo were found in 54.0% and 6% cases. FT4 level was reduced in 100.0% cases (Normal range of FT4-9.14-23.81 pmol/L). The mean of FT4 was 5.10 pmol/L. On the other hand TSH level increased in all cases (Normal range of TSH-0.47-5.0l mIU/L). The mean of TSH was 109.88 mIU/L. 50 cases were positive anti TG-Ab and also anti PO-Ab was positive in Fifty cases. Hemoglobin concentration was reduced in 70.0% cases. The mean of haemoglobin concentration was 10.67 gm/dl. In this present study, association of serum anti TG Ab and anti PO Ab of the patients with hypothyroidism and their corresponding hemoglobin concentration were found significant (p<0.05) but on the other hand there was no association between serum FT4 of the patients with hypothyroidism and their corresponding haemoglobin concentration (p> 0.05). Normocytic normochromic anaemia were found in 64.0% cases, and Microcytic hypochromic anaemia in 32% and Macrocytic anaemia in 4.0% of the cases. Iron deficiency was found in 90.0% and chronic blood loss in 44.0% of the cases. Conclusion: Anaemia is frequently found in hypothyroid patients. So, hypothyroidism should be excluded in anaemia of nonspecific origin. Bangladesh Med Res Counc Bull 2020; 46(1): 55-60

Highlights

Hypothyroidism is a clinical syndrome that results from deficiency of the thyroid hormones, thyroxine (T4) and tri-iodothyronine (T3)
Hypothyroidism is more common in women than in men, but anaemia is more common in hypothyroid men than in hypothyroid women.[4]
Fifty cases were selected by inclusion criteria who had been attended in the "Thyroid and Endocrine Clinic" at BSMMU

Summary

Introduction

Hypothyroidism is a clinical syndrome that results from deficiency of the thyroid hormones, thyroxine (T4) and tri-iodothyronine (T3). The prevalence of hypothyroidism in U.K. is about 15/1000 in females and 1/1000 in Males.[1] Whereas according to Thyroid Clinic at BSMMU, Dhaka about 10-12 percent patients were present with hypothyroidism in that Thyroid Clinic.[2] The cause of hypothyroidism may be primary thyroid disease or, much less commonly, disease of the Prevalence of hypothyroidism in endemic area is more common. Anaemia is very common in hypothyroid patient. The results of the type of anaemia in hypothyroid patient studied outside may not be similar on Bangladeshi population. There is no such study regarding the types of anaemia in hypothyroid patients in Bangladeshi population

Methods

Results

Discussion

Conclusion