Study of thyroid function in Egyptian children with β-thalassemia major and β-thalassemia intermedia

Abdel-Razek, A. S.; Abdelsalam, A.; El-Sonbaty, Marwa M.; Youness, Eman R.

doi:10.1097/01.epx.0000436490.10201.28

Cited by 11 publications

(24 citation statements)

References 22 publications

(19 reference statements)

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“…All the 4 children received regular blood transfusions and oral iron chelation therapy. This is similar to other published studies done by Sharma et al [ 15 ] and Abdel-Razek et al [ 16 ] where subclinical hypothyroidism was most frequently reported. There was no evidence of autoimmune thyroiditis in children with thyroid dysfunction in our study.…”

Section: Discussionsupporting

confidence: 93%

“…But there was no statistical significance noticed between serum ferritin levels and pattern of thyroid impairment (p value of 0.806) consistent with the studies done by Soliman et al [ 17 ] and Zervas [ 13 ] and in contrast with the study done by Chirico et al [ 21 ] which proved ferritin as a prognostic marker for BTM patients and a predictive factor for progression to thyroid dysfunction. The mean TSH value among the thyroid dysfunction group was 6.38 ± 0.83 mIU/ml which is similar to a study done by Garadah [ 10 ] on thalassemic patients where the mean TSH value was 6.78 ± 1.5mIU/ml; however studies done by Abdel Razek [ 16 ] and Somchit Jaruratanasiriku [ 7 ] showed mean TSH values of 4.5±4.8 mIU/ml and 5.9±15.6 mIU/ml, respectively, among children with subclinical hypothyroidism. Statistical significance was found between TSH and thyroid dysfunction (p value= 0.001) ( Table 2 ), consistent with the study done by Garadah [ 10 ] with a p value < 0.01.…”

Section: Discussionsupporting

confidence: 86%

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

Upadya

Rukmini

Sundararajan

et al. 2018

International Journal of Pediatrics

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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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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 86%

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

Upadya

Rukmini

Sundararajan

et al. 2018

International Journal of Pediatrics

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“…The frequency of subclinical HT in TM patients was 15.4% in Bahrain ( 26 ), 23.5% in India ( 27 ), 17.6% in Thailand ( 28 ), 12.3% in Italy ( 13 ), 20.6% in Egypt ( 16 ), and 6.3% in Qatar ( 17 ). The occurrence of HT was generally lower in our study, compared to the majority of previous reports ( 10 - 17 ).…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism and Hypoparathyroidism in Thalassemia Major Patients: A Study in Sistan and Baluchestan Province, Iran

Bazi

Harati

Khosravi-Bonjar

et al. 2018

Int J Endocrinol Metab

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BackgroundHypothyroidism (HT) and hypoparathyroidism (HPT) are common endocrine complications in thalassemia major (TM) patients.ObjectivesIn the present study, we assessed the frequency of HT and HPT in a population of TM patients in Southeast of Iran.MethodsThis cross sectional study was performed on 194 TM patients in Zabol, Sistan and Baluchestan Province, Iran, during February - July 2016. The demographic, clinical, and laboratory data were collected via interviews and history - taking. For hormone measurements, specific ELISA kits were used. Statistical analysis was performed in SPSS version 16.ResultsA total of 103 (53.1%) and 91 (46.9%) females and males were recruited in this study, respectively. The mean age of the patients was 15 ± 7.5 years. HT and HPT showed overall frequencies of 8.2% (18/194) and 18% (35/194), respectively. Subclinical and overt HT were observed in 13 (6.7%) and 5 (2.6%) patients, respectively. There was no significant association between HT and age, while patients with HPT were significantly older than those without HPT (20.1 ± 5.8 vs. 13.9 ± 6.2 years; P < 0.001). HPT was significantly associated with the mean received blood per transfusion (P = 0.009), total transfused blood per year (P = 0.01), splenomegaly (P < 0.001), splenectomy (P < 0.001), hepatomegaly (P = 0.01), and chelation regimen (P < 0.001). The ferritin level was correlated with neither HT nor HPT. Also, no significant difference was observed between patients with or without HT or HPT regarding the cooccurrence of either diabetes or hepatitis C virus (HCV) infection. In the multivariate analysis, splenectomy remained an independent risk factor for HPT after correction for potential covariates (OR, 6.5; 95% CI, 1 - 39.2; P = 0.04).ConclusionsIn patients with TM, HT was a complication with a relatively low frequency, while HPT was more common. Based on the findings, HPT was more frequent in older patients receiving regular blood transfusions, thereby necessitating close monitoring of these patients.

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“…[21][22][23][24] The frequency of hypothyroidism shows a discrepancy depending on the region, quality of management, and treatment protocols. [3,[21][22][23][24] The reported frequency of thyroid dysfunctions ranges between 13% and 60% in different studies and occurs after 10 years of age regardless of difference in the rate of prevalence, largely as in the form of subclinical hypothyroidism. [21][22][23][24] We have documented a prevalence of CH of 6% in patients with a chronological age below 21 years and 7.9% in those above 21 years.…”

Section: Hypothyroidismmentioning

confidence: 99%

“…[3,[21][22][23][24] The reported frequency of thyroid dysfunctions ranges between 13% and 60% in different studies and occurs after 10 years of age regardless of difference in the rate of prevalence, largely as in the form of subclinical hypothyroidism. [21][22][23][24] We have documented a prevalence of CH of 6% in patients with a chronological age below 21 years and 7.9% in those above 21 years. [25] Clinicians should be alert for the diagnosis of CH through accurate interpretation of thyroid function tests.…”

Section: Hypothyroidismmentioning

confidence: 99%

Endocrine Complications

Sanctis¹

2018

Thalassemia Reports

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Study of thyroid function in Egyptian children with β-thalassemia major and β-thalassemia intermedia

Abstract: Both TM and TI patients are at risk for subclinical thyroid failure regardless of their iron overload status. Early evaluation of thyroid function in β-thalassemia children and thyroid replacement therapy for subclinical hypothyroidism should be introduced in the treatment protocols.

Cited by 11 publications

References 22 publications

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

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

Hypothyroidism and Hypoparathyroidism in Thalassemia Major Patients: A Study in Sistan and Baluchestan Province, Iran

Endocrine Complications

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