Comparison of thyroid function tests between splenectomised and non-splenectomised β-thalassemia major patients

Abstract

This study was to evaluate and compare thyroid function tests and serum levels of ferritin in splenectomised and non-splenectomised β-thalassemic patients. This study is a case control study that was conducted in the Thalassemia Center in Ibn Al-Atheer Teaching Hospital in Nineveh Province/ Iraq during March-June 2014. Fifty patients of homozygous β-thalassemia major (TM) and twenty five apparently healthy controls were included in this study. The patients were divided into splenectomised and non-splenectomised patients (each 25 patients). Medical history and blood samples were collected from all participants and serum levels of Thyroid stimulating hormone (TSH), Thyroxine (T4), Free thyroxine (FT4), Triiodothyronie (T3), Free triiodothyronine (FT3), and ferritin in addition to body mass index (BMI) were measured.
 There were significant decreases in BMI and serum FT4, while there were significant increases in serum TSH and ferritin in β-thalassemia major (in which 10% were diagnosed with hypothyroidism) in comparison with control participants. No significant differences were found between splenectomised and non-splenectomised patients in all parameters measured except a significant positive correlation between serum ferritin and TSH and a significant negative correlation between serum ferritin and T4 that reflects 16% hypothyroidism in splenectomised patients. In addition, significant increases were found in serum TSH and ferritin and a significant decrease in serum FT4 in splenectomised patients when compared with the control. Moreover, a comparison of non-splenectomised patients with control group showed no significant difference in all parameters measured except a significant increase in serum ferritin level. In conclusion, there were certain significant differences in thyroid function tests between β-thalassemia major patients and the controls, whereas there were no significant differences in the means of all studied parameters between splenectomised and non- splenectomised patients except for the positive significant correlation of serum ferritin with TSH level in splenectomised patients which reflect the hypothyroidism in splenectomised TM patients.