Correlation with iron overload and thyroid dysfunction in children with thalassemia on regular transfusion therapy

Abstract

BACKGROUND: Thalassemia majoris a hereditary anemia which is caused by defective synthesis of hemoglobin, ineffective erythropoiesis and rapid erythrocyte breakdown.Transfusions in beta thalassemia major are necessary for survival of these patients.Frequent blood transfusions and inadequate iron chelation therapy can result in iron overload which may lead to various endocrine complication such as Thyroid dysfunction, Cardiomyopathy, Daibetes Mellitus, Hypogonadism. OBJECTIVES:To study the frequency of hypothyroidism in thalassemia and To study the correlation between iron overload as measured by serum ferritin levels and incidence of thyroid dysfunction, in children with thalassemia major on regular transfusion therapy. METHODS:This is asingle center cross sectional study including 91 children attending thalassemia day care center and on regular blood transfusion therapy for a minimum of 2 years. Detailed history and examination were recorded in the proforma. Blood was drawn for serum ferritin levels and thyroid function tests in these children. RESULTS: Subclinical hypothyroidism was found in 21% of children in our study. 17 children had subclinical hypothyroidism and 2 had compensated hypothyroidism. There was no correlation between serum ferritin levels and thyroid dysfunction. CONCLUSION: Hypothyroidism was found to be a complication of thalassemia in around 21% children in our study. Detection of hypothyroidism is important as effective replacement therapy is available.. Therefore, thyroid function should be followed periodically, particularly when other iron overload-associated complications occur. Early recognition and hence prevention of these complications might help improve the quality of life of these patients.