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

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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Thyroid Function in Chronically Transfused Children with Beta Thalassemia Major: A Cross-Sectional Hospital Based Study

International Journal of Pediatrics ◽

10.1155/2018/9071213 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Suraj Haridas Upadya ◽

M. S. Rukmini ◽

Sowmya Sundararajan ◽

B. Shantharam Baliga ◽

Nutan Kamath

Keyword(s):

Thyroid Function ◽

Serum Ferritin ◽

Subclinical Hypothyroidism ◽

Thyroid Dysfunction ◽

Genetic Disorder ◽

Thalassemia Major ◽

Beta Thalassemia ◽

P Value ◽

Blood Transfusions ◽

Beta Thalassemia Major

Background. Thalassemia is the most common genetic disorder worldwide. Use of iron chelators has improved survival but endocrine complications have become more frequent. The frequency of hypothyroidism in Beta Thalassemia Major (BTM) children ranges from 6 to 30 %. Thyroid dysfunction mainly occurs by gland infiltration, chronic tissue hypoxia, free radical injury, and organ siderosis. Objectives. (a) To evaluate the thyroid function status in chronically transfused children with BTM, in the first and second decade of life and (b) to study the influence of factors like duration and amount of blood transfusions, serum ferritin level, and iron chelation therapy on thyroid function. Methodology. BTM children, 3 years old and above, on regular blood transfusions with serum ferritin > 1500 mcg/l were included in the study. Thyroid function and ferritin assessment was done using ELISA kits. Autoimmune thyroiditis was ruled out by antithyroid peroxidase and antithyroglobulin antibody testing. Results. A study population of 83 children consisted of 49 boys (59%) and 34 girls (41%). 4.8% of the children had evidence of subclinical hypothyroidism. Among them two belonged to the first decade and the other two to the second decade of life. Mean TSH, FT4, and ferritin values among children with thyroid dysfunction were 6.38 ± 0.83 mIU/ml, 1.08 ± 0.45 ng/dl, and 3983.0±1698.30 ng/ml, respectively. The severity of thyroid dysfunction was statistically significantly associated with higher serum TSH values in children in the second decade of life with a p value = 0.001. No other significant correlation was found between oral chelation, amount and duration of blood transfusion, or serum ferritin levels. Conclusion. Subclinical hypothyroidism was the thyroid dysfunction observed in our study. Regular blood transfusions with adequate chelation may decrease incidence of thyroid dysfunction.

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Relationship between Short Stature and Serum Ferritin in Children with Beta Thalassemia Major

Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramification Researches ◽

10.5220/0010098908910897 ◽

2018 ◽

Author(s):

S. M. Lubis ◽

B. Lubis

Keyword(s):

Short Stature ◽

Serum Ferritin ◽

Thalassemia Major ◽

Beta Thalassemia ◽

Beta Thalassemia Major

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Thyroid profile in patients of thalassemia with multiple blood transfusions and high serum ferritin: a cross-sectional study

Pediatric Review International Journal of Pediatric Research ◽

10.17511/ijpr.2020.i08.02 ◽

2020 ◽

Vol 7 (8) ◽

pp. 401-408

Author(s):

Dr. Rohit Khandelwal ◽

◽

Dr. Muralidhar Gundluru ◽

Dr. Leeni Mehta K. ◽

◽

...

Keyword(s):

Serum Ferritin ◽

Thyroid Dysfunction ◽

Ferritin Level ◽

Thalassemia Major ◽

High Serum ◽

The Body ◽

Beta Thalassemia ◽

Blood Transfusions ◽

Beta Thalassemia Major ◽

Tsh Levels

Introduction: Beta-thalassemia major patients undergo regular blood transfusion resulting ingrowth faltering and various endocrine problems including thyroid dysfunction due to iron overloadin the body. This study was conducted to determine the frequency of thyroid dysfunction in childrenpresenting with Beta-thalassemia major on regular blood transfusions. Materials and methods:Sixty children were included with proven beta-thalassemia major who reported to the Department ofPediatrics, VIMS, and RC, Bangalore. Inclusion criteria: 1.Children 4 to 18 years age group .2.Thechild received transfusions for more than 2 years. 3.Children with serum ferritin level >700.Results: In this study, four patients(6.8%) had overt hypothyroidism, eight patients(13.6%) hadsubclinical hypothyroidism and 47 patients(79.7%) had euthyroid status. There was a positivecorrelation between Ferritin and T4, TSH levels. i.e., with an increase in Ferritin level, there was anincrease in T4, TSH levels, and vice versa. However, the correlation was significant with TSH. Therewas a significant negative correlation between Ferritin and T3 levels. i.e with an increase in Ferritinlevel, there was a decrease in T3 levels and vice versa. Conclusion: Thyroid dysfunction can exist inthalassemia patients on multiple transfusions and chelation therapy with high serum ferritin levels.Detection of hypothyroidism is important as inexpensive oral replacement therapy is readilyavailable. Hence regular screening of beta-thalassemia major patients for Serum T3, Serum T4,Serum TSH for early detection and timely treatment could improve the life expectancy and quality oflife of these patients.

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Serum IGF-1 and short stature in adolescents with beta-thalassemia major

Paediatrica Indonesiana ◽

10.14238/pi58.4.2018.151-8 ◽

2018 ◽

Vol 58 (4) ◽

pp. 151-8 ◽

Cited By ~ 1

Author(s):

Monalisa Elizabeth ◽

Eddy Fadlyana ◽

Lelani Reniarti ◽

Faisal Faisal ◽

Hadyana Sukandar ◽

...

Keyword(s):

Risk Factors ◽

Short Stature ◽

Family Income ◽

Thalassemia Major ◽

Cross Sectional Study ◽

Beta Thalassemia ◽

Growth Chart ◽

Chi Square ◽

Cross Sectional ◽

Beta Thalassemia Major

Background The prevalence of short stature in thalassemia patients ranges from 39.3 to 65%. The cause of short stature is complex and still up for debate. In Indonesia, data on the prevalence and risk factors of short stature in adolescents with thalassemia have been limited. Objective To assess for the prevalence and risk factors of short stature in adolescents with beta-thalassemia major. Methods This cross-sectional study was done from February to March 2017 at the Thalassemia Clinic at Dr. Hasan Sadikin General Hospital, Bandung. The baseline characteristics data of 80 adolescents with thalassemia aged 10-14 years were recorded. Short stature was assessed by height-for-age, (Z-score <-2SD) based on the 2007 WHO Reference Growth Chart. Mid-upper arm circumference was scored according to age and sex and serum IGF-1 was measured by ELISA method. Data analyses used were Chi-square, Fisher’s, and Mann-Whitney tests. Logistic regression model was used to further analyze for risk factors of short stature. Results Subjects were 40 males and 40 females, 81.2% of whom had short stature. The mean serum IGF-1 level was 32.2 (SD 26.38) ng/mL. The IGF-1 cut-off point by ROC curve was £38.51 ng/mL, with sensitivity of 64.4% and specificity of 86.7%. The risk factors of short stature were IGF-1 level £38.51 ng/mL (PR 40.66; 95%CI 4.37 to 377.58; P<0.001) and low family income (PR 19.76; 95%CI: 1.152 to 256.08; P=0.022). Conclusion IGF-1 level may be useful as a predictor of short stature in adolescent beta-thalassemia major patients.

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A Prospective Study of Thyroid Function Status in Patients of Haemoglobin E Beta Thalassemia and Correlation with Serum Ferritin Level

Blood ◽

10.1182/blood.v128.22.4837.4837 ◽

2016 ◽

Vol 128 (22) ◽

pp. 4837-4837

Author(s):

Tuphan Kanti Dolai ◽

Shuvra Neel Baul ◽

Prakas Kumar Mandal ◽

Rajib De ◽

Prantar Chakrabarti

Keyword(s):

Correlation Coefficient ◽

Serum Ferritin ◽

Subclinical Hypothyroidism ◽

Thyroid Dysfunction ◽

Serum Ferritin Level ◽

Conflicts Of Interest ◽

Ferritin Level ◽

Thyroid Status ◽

Beta Thalassaemia ◽

Serum Tsh

Abstract Introduction Haemoglobin E-beta-thalassaemia (EBT) represent approximately 50 per cent of those affected with severe beta thalassemia.The highest frequencies are observed in India, Bangladesh and throughout Southeast Asia. Endocrinopathies are now amongst the common complications of thalassaemia and it is multifactorial in origin. Iron overload in EBT is also multifactorial. This study was undertaken to evaluate the thyroid dysfunction in patients of EBT and its correlation with serum ferritin levels. Methods EBT patients were evaluated prospectively to assess thyroid dysfunction status and correlate it with serum ferritin levels. High performance liquid chromatography was performed with Bio-rad beta thalassaemia short program variant II. Serum ferritin estimation was done with microplate immunoenzymometric assay and thyroid assay for TSH, free T4 and T3 were done by access 2 Immunoassay System, Beckman Coulter. Results 50 patients with EBT were evaluated. The mean age of patients were 19.7 years (range: 12-47). There were 28 males and 22 females. There were 41(82%) and 9(18%) transfusion dependent and transfusion independent patients respectively and 40(80%) were on chelation therapy. In this cohort 22(44%) patients had thyroid dysfunction. Six (12%) and 16(32%) of patients were having hypothyroidism and subclinical hypothyroidism respectively. Mean ± Standard deviation (S.D) of serum ferritin level with hypothyroidism, subclinical hypothyroidism and euthyroidism was 1077 ± 371.8 ng/ml ,1422 ± 1361.0 ng/ml and 1252 ± 664.4 ng/ml respectively with correlation coefficient =0 [Fig 1 and Fig 2]. Serum ferritin levels do not predict thyroid dysfunction in patients of EBT. Male and female have equal preponderance for thyroid dysfunction. Patients with subclinical hypothyroidism were having few symptoms compared to frank hypothyroidism and majority of symptoms in either scenario were masked by thalassemia itself. Earlier age of onset of EBT is associated more with thyroid dysfunction however the association is not statistically significant (p=0.2). There was no association between spleen size and thyroid dysfunction (p=0.7). Conclusions Thyroid dysfunction was seen in 42% of EBT patients. Prevalence of hypothyroidism was found to be higher in EBT patients compared to general population but a definite correlation with the serum ferritin levels could not be established. Figure 1 Mean serum ferritin level and thyroid status Figure 1. Mean serum ferritin level and thyroid status Figure 2 Correlation of serum TSH and ferritin level (correlation coefficient =0) Figure 2. Correlation of serum TSH and ferritin level (correlation coefficient =0) Disclosures No relevant conflicts of interest to declare.

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Correlation of liver enzymes with serum ferritin levels in beta-thalassemia major

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20162278 ◽

2016 ◽

pp. 3271-3274 ◽

Cited By ~ 2

Author(s):

Rameshwar Suman ◽

Anuradha Sanadhya ◽

Pradeep Meena ◽

Suresh Goyal

Keyword(s):

Serum Ferritin ◽

Liver Enzymes ◽

Thalassemia Major ◽

Beta Thalassemia ◽

Beta Thalassemia Major

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Correlation of myocardial performance index and serum ferritin levels in children with beta thalassemia major

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20151386 ◽

2016 ◽

pp. 22-27 ◽

Cited By ~ 3

Author(s):

Jagadisha Siddammanahalli ◽

Mallesh Kariyappa ◽

Premalatha Ramaswamy ◽

Shwetha NH ◽

Ganga Kusuma

Keyword(s):

Serum Ferritin ◽

Performance Index ◽

Thalassemia Major ◽

Myocardial Performance Index ◽

Beta Thalassemia ◽

Myocardial Performance ◽

Beta Thalassemia Major

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PREVALENCE OF HYPOTHYROIDISM, DELAYED PUBERTY AND DIABETES MELLITUS IN PATIENTS OF Β-THALASSEMIA MAJOR

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i3.1017 ◽

2020 ◽

Vol 4 (3) ◽

Author(s):

Naresh Manne ◽

Bharat Kumar Gupta ◽

Sandeep Kumar Yadav ◽

Saurabh Singhal ◽

Archana Dubey

Keyword(s):

Diabetes Mellitus ◽

Blood Transfusion ◽

Serum Ferritin ◽

Serum Ferritin Level ◽

Ferritin Level ◽

Thalassemia Major ◽

Delayed Puberty ◽

Beta Thalassemia ◽

Endocrine Disorders ◽

Beta Thalassemia Major

Background: Beta-Thalassemia is a genetic disorder which is associated with a lot of complications. Frequent blood transfusions result in increased iron deposition in various tissues leading to dysfunction of many vital organs. Endocrine disorders constitute a major part of such complications increasing the morbidity of thalassemia manifold in the affected patients. Methods: This is a descriptive cross sectional study carried out in 100 diagnosed patients of beta- thalassemia major who had visited the OPD/IPD of Subharti Medical College & affiliated Hospitals, Meerut for routine blood transfusion or for any other complication. Patients were clinically examined and investigated for presence of one or more endocrine disorders on their routine appointments. Results: Endocrine disorders were detected in a total of 82 patients. Diabetes mellitus was detected in 12% patients, hypothyroidism in 36% patients and delayed puberty was found in 72% patients. Mean serum ferritin level was found to be 5831.0±2860.5 ng/ml in beta-thalassemia Major patients, while it was in normal range in control subjects. Conclusion: Research concluded with finding of Delayed puberty (72%), Hypothyroidism (36%) and diabetes mellitus as (12%) in beta thalassemia patients who were on regular blood transfusion therapy. Iron overload as serum ferritin level was found to be highly raised in all study case. On the basis of our study we recommend that early detection and management protocols for these endocrinopathies may improve the life prospects of beta-thalassemia Major patients. Keywords: Endocrine disorders, Hypothyroidism, Delayed puberty, Diabetes Mellitus Serum ferritin, Thalassemia Major.

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