Abstract
Objectives & introduction: Thalassemia, heterogenous group of disorders of haemoglobin,characterised by reduced or absent production of one or more of globin chains.Regular redcell transfusion with chelation therapy for iron overload are cornerstones of therapy for ßthalassemia major. Serum ferritin assay is widely available, relatively inexpensive methodfor assessing body iron burden and monitoring response to chelation process which in turnalso improves TSH levels in thalassemic subjects .The objective of this study was to assessprechelation and postchelation levels of serum ferritin and TSH and correlating post chelationlevels of serum ferritin and TSH in thalassemic patients >6yrs undergoing chelation therapy.
 Materials & methods: Serum TSH measured by Enzyme linked fluorescent assay and serumferritin measured by enzyme linked immunosorbent assay.
 Results: Amongst 500 participants,47% were males & 53% females. Mean age was 9.04 yrs ;prechelation ferritin and TSH levelswere 2995.78ng/ml with SD of 802.53 and 5.07 μU/ml with SD of 2.52. The postchelationferritin and TSH levels were 2168.80 ng/ml with SD of 1335.89 and 4.51μU/ml with SD of4.76. Paired t test with respect to pre and postchelation ferritin and TSH levels showed 2 tailed pas 0.000 and t>3, both of which considered significant. While correlating post chelation ferritinwith TSH levels; they showed a linear correlation ( Pearson coefficient of .836).
 Conclusion:Serum ferritin and TSH estimation in prechelation and postchelation periods give an estimateof iron overload with effect of chelation on it. Both levels decrease post chelation presenting alinear correlation between the two.
 Bangladesh Journal of Medical Science Vol.20(1) 2021 p.130-135
Highlights
Thomas Cooley and Lee described the homozygous or compoundheterozygous state for a recessive Mendelian disorder not confined to the Mediterranean,But occurring widely throughout tropical countries
Chronic blood transfusion is associated with many untoward complications like blood borne infections, isoimmunisation, febrile reactions and iron overload
Iron overload causes serum ferritin level to be raised in thalassemia
Summary
Thomas Cooley and Lee described the homozygous or compoundheterozygous state for a recessive Mendelian disorder not confined to the Mediterranean,But occurring widely throughout tropical countries. In the past 20 years, the two important Forms of this disorder,α- and β-thalassemia, resulting from the defective synthesis of the α-and β-globin chains of hemoglobin, respectively, have been recognized as the most common monogenic diseases in humans.[1,2,6]. Chronic blood transfusion is associated with many untoward complications like blood borne infections, isoimmunisation, febrile reactions and iron overload. Iron overload causes serum ferritin level to be raised in thalassemia. There are no mechanisms for increasing the excretion of iron beyond normal daily losses.Iron rapidly accumulates in chronically transfused patients. Common clinical complaints in iron overload include lethargy, weight loss, change in skin color, loss of libido abdominal pain and joint pain.[4,5,7,8]
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