Study of thyroid functions in transfusion dependent thalassemia patients of pediatric age group with reference to serum ferritin level in a tertiary care centre

Abstract

Hypothyroidism is one of the most common endocrine complication in transfusion dependent thalassemia patients. Its prevalence and severity is variable and the natural history is poorly described. The frequency of hypothyroidism in Beta Thalassemia Major (BTM) children ranges from 6 to 30%. To determine the levels of serum TSH and FT4 in patients with transfusion-dependent thalassemia (TDT), as well as their relationship to the degree of iron excess indicated by serum ferritin levels. This observational descriptive study was undertaken on 200 patients (5 to15 yrs of age) in the department of Pediatrics in SCB Medical College, Cuttack, Odisha, India from to after obtaining clearance from institutional ethical committee. Out of total 200 TDT children, 141(70.50%) were euthyroid and 59(29.50%) were hypothyroid. Among hypothyroid children, 9(4.5%) had overt hypothyroidism and 50(25%) children had subclinical hypothyroidism. In children <10 years of age group there was a positive correlation between serum ferritin and rise in serum TSH (p < 0.05, r= .553). The rise in serum ferritin was statistically not significant with fall in serum FT4 (p < 0.05, r= .122). In children >10 years of age group, there was positive correlation between serum TSH and serum ferritin (p < 0.05,r=.845). There was an inverse relation between rise in serum ferritin and fall in serum FT4 (p < 0.05, r= -.406). Hypothyroidism was associated in significant number of transfusion dependent thalassemia patients. Adequate iron chelation therapy to keep serum ferritin level within normal limit and early detection of hypothyroidism preferably below 10 years of age will prevent hypothyroidism and its complications in transfusion dependent thalassemia.