Evaluation of the Thyroid Status and Types of Thyroid Dysfunction in Beta-Thalassemia Major Patients More Than 9 Years of Age in Wassit, Iraq 2020

Authors

  • Ahmed I. I. Ansaf Department of Pediatrics, College of Medicine, Wasit University, Al Kut, Wasit, Iraq
  • Safa Faraj Department of Pediatrics, College of Medicine, Wasit University, Al Kut, Wasit, Iraq https://orcid.org/0000-0002-4126-055X
  • Hussien A. Abdul-Azziz Department of Pediatrics, Al-Kut Materntiy and Child Hospital, Kut, Iraq

DOI:

https://doi.org/10.3889/oamjms.2021.7407

Keywords:

Beta-thalassemia major, Hypothyroidism, Serum ferritin, Short stature

Abstract

Background: Hypothyroidism is one of the commonest endocrine complications that can happen in patients with Beta-Thalassemia Major (BTM) above nine years old which may pass hidden and untreated for years.  

Aim: To evaluate the thyroid status and types of thyroid dysfunction in Beta-Thalassemia Major Patients above 9 years of age.

Method: A Cross-Sectional study was performed on sixty-six randomly selected patients above 12 years of age with BTM in Al-Kut Heriditory Blood Disease Center at Wassit province from March to August 2020. Thyroid function tests were done (TSH, T3, and T4) to detect the thyroid status and identify patients with thyroid dysfunction and determine the type of hypothyroidism (Primary, central, Subclinical). Data collected include Age, Sex, weight, height, Serum ferritin and mean hemoglobin level, Type of chelation therapy, dose, compliance, and frequency of blood transfusion, other diseases such as Diabetes Mellitus, HCV, HBV, HIV, and Heart Failure were evaluated statistically.

Results:   In the studied patients, Thirty-one patients (46.96%) were found to have hypothyroidism;( Seven of them (10.6%) had primary hypothyroidism, Sixteen(24.2%) had subclinical hypothyroidism and eight (12.1%) had central hypothyroidism).

 Twenty-one (67.74 %) patients with Hypothyroidism were found to have stunted height or short stature (with significant p.value 0.03) from the 13 (41.9%) who had subclinical hypothyroidism.

 By Pearson correlation, increasing serum ferritin levels significantly affect decreasing thyroxin (T4) levels with inverse correlation (P value 0.0001), (r)= -0.45.

Conclusion:  in this study, there was a high prevalence of hypothyroidism in BTM and subclinical hypothyroidism is the most common type, which signifies the importance of regular screening and close supervision especially when high ferritin and or short stature are present.

 

 

 

 

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Author Biographies

Ahmed I. I. Ansaf , Department of Pediatrics, College of Medicine, Wasit University, Al Kut, Wasit, Iraq

 

 

Safa Faraj, Department of Pediatrics, College of Medicine, Wasit University, Al Kut, Wasit, Iraq

 

 

Hussien A. Abdul-Azziz , Department of Pediatrics, Al-Kut Materntiy and Child Hospital, Kut, Iraq

 

 

 

References

De Sanctis V, Roos M, Gasser T, Fortini M, Raiola G, Galati MC. Impact of long-term iron chelation therapy on growth and endocrine functions in thalassaemia. J Pediatr Endocrinol Metab. 2006;19(4):471-80. PMid:16759032

Borgna-Pignatti C, Cappellini MD, De Stefano P, Del Vecchio GC, Forni GL, Gamberini MR, et al. Cardiac morbidity and mortality in deferoxamine-or deferiprone-treated patients with thalassemia major. Blood. 2006;107(9):3733-7. http://doi.org/10.1182/blood-2005-07-2933 PMid:16373663 DOI: https://doi.org/10.1182/blood-2005-07-2933

Farmaki K. Hypothyroidism in thalassemia. In: Hypothyroidism Influences and Treatments. Vol. 1. Rijeka, Croatia: InTeach; 2012. p. 97-110. DOI: https://doi.org/10.5772/33103

Zekavat OR, Makarem AR, Haghpanah S, Karamizadeh Z, Javad P, Karimi M. Hypothyroidism in β-thalassemia intermedia Patients with and without hydroxyurea. Iran J Med Sci. 2014;39(2):60-3. PMid:24453395

Abdel-Razek AR, Abdel-Salam A, El-Sonbaty MM, Youness ER. Study of thyroid function in Egyptian children with β-thalassemia major and β-thalassemia intermedia. J Egypt Public Health Assoc. 2013;88(3):148-52. http://doi.org/10.1097/01.EPX.0000436490.10201.28 PMid:24374948 DOI: https://doi.org/10.1097/01.EPX.0000436490.10201.28

Rehman H, Masood J, Sheikh S, Mehboob Q. Frequency of hypothyroidism in patients of beta thalassemia major. APMC. 2019;13(1):4-6.

Soliman AT, Al Yafei F, Al-Naimi L, Almarri N, Sabt A, Yassin M, et al. Longitudinal study on thyroid function in patients with thalassemia major: High incidence of central hypothyroidism by 18 years. Indian J Endocrinol Metab. 2013;17(6):1090-5. http://doi.org/10.4103/2230-8210.122635 PMid:24381890 DOI: https://doi.org/10.4103/2230-8210.122635

Bernal J. Thyroid Hormones in Brain Development and Function. In: Endotext. South Dartmouth, MA: MDText. Com, Inc.; 2015.

Jehanzeb K, Ahmad F, Lodhi MA, Ali S. Thyroid function assessment with B-thalassemia Major. Pak Armed Forces Med J. 2016;66(6):809-13.

Eshragi P, Tamaddoni A, Zarifi K, Mohammadhasani A, Aminzadeh M. Thyroid function in major thalassemia patients: Is it related to height and chelation therapy? Caspian J Intern Med. 2011;2(1):189-93. PMid:24024013

Azami M, Parizad N, Sayehmiri K. Prevalence of hypothyroidism, hypoparathyroidism and the frequency of regular chelation therapy in patients with thalassemia major in Iran: A systematic review and meta-analysis study. Iran J Ped Hematol Oncol. 2016;6:261-76.

Malik SA, Syed S, Ahmed N. Frequency of hypothyroidism in patients of beta thalassemia. J Pak Med Assoc. 2010;60(1):17-20. PMid:20055273

Rotaur I, Gaman A, Gaman G. Secondary haemochromatosis in a patient with thalassemia intermedia. Curr Health Sci J. 2014;40(1):67-70. http://doi.org/10.12865/CHSJ.40.01.13 PMid:24791210

Sharma S, Aggarwal R. Evaluation of thyroid hormones in Beta-thalassemic children of north India. UJMDS. 2014;2(1):39-42. DOI: https://doi.org/10.1155/2014/543860

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Published

2021-11-12

How to Cite

1.
I. Ansaf AI, Faraj S, Abdul-Azziz HA. Evaluation of the Thyroid Status and Types of Thyroid Dysfunction in Beta-Thalassemia Major Patients More Than 9 Years of Age in Wassit, Iraq 2020. Open Access Maced J Med Sci [Internet]. 2021 Nov. 12 [cited 2024 Mar. 29];9(B):1405-9. Available from: https://oamjms.eu/index.php/mjms/article/view/7407