Abstract

ASSESSMENT OF THYROID FUNCTION IN MULTI-TRANSFUSED CHILDREN OF ? THALASSEMIA MAJOR WITH IRON OVERLOAD

Dr. Ummed Singh Solanki, Dr. Ajay Kumar Bhargava, Dr. Prashant S. Adole

ABSTRACT

Transfusion related iron overload is the primary therapeutic complication in thalassemia major. Iron deposition in various endocrinal glands (including thyroid gland) is responsible for the hormonal derangements. Other factors like hypoxia due to persistent anaemia and perfusion defect, also contribute to the derangement. In India, cost of chelation precludes ideal therapy for majority of the patients and the compliance with transfusion is often not optimal. Therefore there is a possibility that there may be high prevalence of hypothyroidism in thalassemic children in India. In view of very few pediatric Indian studies, we therefore planned the present study. In the present study, we aimed to assess thyroid function in children suffering from β-thalassemia major with iron overload and to evaluate its relation, if any, with serum ferritin levels. 50 confirmed β-thalassaemia major cases, with ferritin level more than 1000, and who were on regular transfusion for more than 2 years, in the age group 3-14 years, were recruited in the study. 50 age and gender matched healthy controls were also recruited in the study. Thyroid profile and serum ferritin levels were measured using Chemiluminescence Immunoassay (CLIA) method. Compared to the control group, the mean level of thyroid hormones (both T3 and T4) and hemoglobin (Hb) levels were significantly reduced while that of TSH was increased significantly. Out of 50 cases, 32(64%) were euthyroid, 17(34%) and 1(2%) had subclinical and clinical hypothyroidism respectively. There was no significant correlation between serum T3, T4 and Ferritin levels. Also there was no significant correlation between serum TSH and Ferritin levels. Though thyroid dysfunction in thalassemia may start early in life, hypothyroidism is not clinically observed in most thalassemia major patients. Therefore, thyroid function should be followed periodically, particularly when other iron over loadassociated complications occur

Keywords: ?-thalassemia, ferritin, thyroid profile, hypothyroidism.