Some endocrinal changes in children with β-thalassemia major

Abstract

Background Endocrinal disorders are well-described in patients with β-thalassemia major (BTM) and are among the most common consequences of the disease worldwide affecting patient's quality of life and causing considerable morbidity and mortality. Even with iron chelating agents, the rate of endocrinopathies remains high among thalassemia major patients. Aims To study the thyroid & parathyroid glands functions in children with Beta- thalassemia and find out the influence of iron overload on them. Patients and Methods This study was carried out on 35 children diagnosed as Beta-thalassemia major and 15 healthy children as a control group who attended the outpatient clinic as well as the inpatient Pediatric Department, Qena University Hospital. All patients were subjected to thorough medical history, clinical examination and abdominal ultrasound. Laboratory investigations were done to confirm diagnosis and severity of the disease and iron status. Calcium, phosphorus, TSH, T3 & T4 and Parathormone (PTH) levels were detected to find out the thyroid and parathyroid gland functions. Results There were significant increase in TSH and decrease in T4 and PTH levels in cases than in control. There were also significant increase in TSH and significant decrease in T4 & PTH level regarding age but not significant with sex. Height was significantly lower in cases than control. According to the clinical data, the present study showed that TSH level was significantly higher and PTH was significantly lower among patients whose duration of illness was ≥6 years, those required frequent blood transfusion and with patients on irregular iron chelation therapy (poorly chelated) and splenectomized cases. There were significant and highly significant difference between TSH and PTH levels and serum ferritin, but there were no significant difference in relation to serum iron, TIBC, HB level, calcium and phosphorus. The present study detected correlations between TSH, PTH and serum ferritin.Conclusion We concluded that there were thyroid and parathyroid endocrinal changes in thalasthemic patients and recommend careful follow up of them by assessments of thyroid and parathyroid hormones as early recognition and hence prevention of these complications might help improve the quality of life of these patients.