Publication:

Thyroid hormone status in children with transfusion-dependent thalassemia

Background Thalassemia, a prevalent genetic disorder, necessitates recurrent blood transfusions for life, precipitating iron overload and premature death. In β-thalassemia major (BTM), hypothyroidism prevalence fluctuates (6-30%) globally, influenced by diverse chelation regimens. The objective of this study is to evaluate the thyroid hormone levels in pediatric patients diagnosed with transfusion-dependent thalassemia (TDT).

Methods A hospital-based cross-sectional study was conducted at the paediatrics department of Sir Salimullah medical college Mitford hospital, Dhaka, focusing on TDT patients aged 4 to 18 years. Exclusions comprised known cases of hypothyroidism, children receiving hormonal therapy, those with a family history of hypothyroidism, and individuals with fewer than 10 blood transfusions. Serum separation involved centrifugation at 3000 rpm for 5 minutes, with subsequent aliquoting into two screw-capped dry clean vials: 1 ml each for FT4/TSH and serum ferritin estimation. Data were analyzed using SPSS version 24.0.

Results Eighty-seven transfusion dependent thalassemia children aged between 4 to 18 years were chosen in this study. The hypothyroidism was seen in 7 (8%) patients. Of these, 4 (4.6%) participants were compensated hypothyroid and 3 (3.4%) participants were uncompensated hypothyroid. Most of the participants were hypothyroidism with Hb E-β thalassemia. The mean serum ferritin level was 2578.49±1385.06 ng/ml. Positive correlation of TSH with duration of disease (in years), total number of blood transfusion times and serum ferritin were statistically significant (p<0.05).

Conclusions The present study demonstrates that 8% of the children with TDT have hypothyroidism. Hypothyroidism is more frequent among Hb E β-thalassemic children as compared to β-thalassemic children.