Abstract
Introduction: The free iron and haemosiderosis-induced damage of the endocrine glands cause endocrinopathies such as abnormal glucose tolerance and hypothyroidism in transfusion - dependent beta-thalassemia major patients. Our objective was to study the association of serum ferritin level with thyroid dysfunctions; abnormal blood glucose tolerance and to see if they appear in the earlier period of life.
 Methods: This cross-sectional study was done among thalassemia major children of two to 12 years in a tertiary care hospital, Kolkata, India. A pre-designed proforma was filled. Serum ferritin, fT4, TSH level, and oral glucose tolerance test (OGTT) were measured at presentation and noted in proforma.
 Results: A total of 80 thalassemic children were studied. Fiftieth percentile cut off value (1414 ng/ml) of serum ferritin was found to be significant with associated variables like normal fT4, TSH, and OGTT. Out of all study subjects, 39 (51.3%) of normal fT4, 39 (54.9%) of normal TSH and 39 (52.0%) of normal OGTT had ferritin < 50th percentile (P < 0.05). Nine (11.3%) children had abnormal thyroid profiles and five (6.3%) children had abnormal OGTT having ferritin > 2000 ng/ml. At a cut off value of ferritin level > 1414 ng/ml, fT4, TSH and OGTT showed significant abnormality (p < 0.05 with df 1).
 Conclusions: Ferritin is a good indirect marker to assess the risk of endocrine abnormality in thalassemic children. Frequent monitoring should be done once ferritin level crosses 1000 ng/ml. This will help in early detection and timely management of thalassemia related endocrinopathies.
Highlights
The free iron and haemosiderosis-induced damage of the endocrine glands cause endocrinopathies such as abnormal glucose tolerance and hypothyroidism in transfusion - dependent beta-thalassemia major patients
Serum ferritin level and TSH levels were significantly correlated with age and serum-free T4 level did not correlate with age
We found that the serum ferritin level was significantly associated with serum TSH level (Positive association) at the value of more than 1414 ng/ml
Summary
The free iron and haemosiderosis-induced damage of the endocrine glands cause endocrinopathies such as abnormal glucose tolerance and hypothyroidism in transfusion - dependent beta-thalassemia major patients. Our objective was to study the association of serum ferritin level with thyroid dysfunctions; abnormal blood glucose tolerance and to see if they appear in the earlier period of life. Thalassemia refers to a spectrum of inherited disorders of haemoglobin synthesis characterised by reduced or lack production of one or more globin chains.[1] Beta thalassemia is due to impaired production of a beta-globin chain, leading to a relative excess of the alpha-globin chain. Children with thalassemia major receive regular blood transfusions to maintain their normal haemoglobin. Regular blood transfusion and increased absorption of iron due to ineffective erythropoiesis lead to excess iron in the body. A complication of iron overload includes endocrine complications {growth retardation, failure of sexual maturation, diabetes mellitus (DM) and insufficiency of the parathyroid, thyroid, pituitary and less commonly adrenal glands}, dilated cardiomyopathy, liver fibrosis, and cirrhosis are other common complications
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
