Thyroid dysfunction in beta thalassemia major patients

Abstract

Background: Endocrinopathies are now amongst the common complications of thalassemia but determining the exact prevalence is difficult because of differences in age of first exposure to chelation therapy and the continuing improvement in survival in well-chelated patients. Hypothyroidism is the second most common endocrine disorder after hypogonadism, having been reported in 5.6% to 17% of patients. Material and Methods: The present study was conducted in Umaid hospital attached to Dr S.N. Medical College, Jodhpur. 112 children were enrolled in the study and thyroid function tests along with serum Ferritin levels were done for all the subjects. Results: Out of a total of 112 children, 82 were Euthyroid (73.2%) and 30 were Hypothyroid (26.8%). The mean serum Ferritin, serum TSH, serum Free T4 and serum Free T3 in Euthyroid children were 1975.4 ± 706.2(ng/ml), 3.23 ± 0.93(μIU/ml), 12.8 ± 2.3(pmol/l) and 6.12 ± 1.4(pmol/l) respectively. Whereas in Hypothyroid children the mean serum Ferritin, serum TSH, serum Free T4 and serum Free T3 were 2842.9 ± 1095.2(ng/ml), 7.05 ± 1.91(μIU/ml), 10.55 ± 2.0(pmol/l) and 4.49 ± 1.2(pmol/l) respectively. Conclusion: Prevalence , severity of thyroid dysfunction in thalassemics is variable and regular follow up is the key. Assessment of thyroid function should be done annually from the age of 9 or earlier if patient is clinically symptomatic.